Medication Non-adherence in the treatment
of patients with Tuberculosis (TB) is a major challenge in community-based clinical
therapeutics. This has been attributed, in part, to duration and complexity of treatment
regimens and toxic side-effects, which facilitates disease transmission with emerging
resistance to anti-TB drugs.
This study was
undertaken to assess level of adherence to treatment and identify social determinants
moderating medication-adherence guided by the PRECEDE framework among patients receiving
treatment in South-west zone of Nigeria.
This was a cross-sectional
survey design conducted as a community-based study with 226 consenting patients
receiving second-line drug treatment based on data obtained from all DR-TB OPD Health
facilities within South-west, Nigeria. The study adopted total enumeration sampling
technique. Data analysis was performed using IBM SPSS version 22. Univariate and
multivariate Regression analysis was conducted to validate the association between
the independent variables (Reinforcing and Enabling factors) and outcome variables
(medication- adherence and appointment keeping behavior). The test of significance
was set at 5% for all statistical procedures.
in this study was 61.3%. Mean treatment-adherence prevalence was 84.75% (20.34±3.37
measured on 24-point scale). Social/Environmental factors correlated positively
with treatment -adherence (r=0.165; p<0.01). Enabling factors with OR=1.44 (95%
CI=1.08-1.92, p=0.013) predicted treatment-adherence more significantly than reinforcing
factors for participants in this study.
of treatment-adherence was fair. Special
attention should be given to enabling and reinforcing factors during patient education
through social learning and structural support, which the study identified as inadequate,
to optimize treatment-adherence in DR-TB patients.
Keywords: Reinforcing, Enabling,
Drug resistance, Tuberculosis, Treatment-adherenc.
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