Patient factors impacting antiretroviral drug adherence in a Nigerian tertiary hospital
Journal of Pharmacology and Pharmacotherapeutics
Department of Pharmacology, Faculty of Pharmaceutical Sciences, University of Jos/APIN Centre, Jos, Nigeria; Department of Pharmacy, University Teaching Hospital, Jos, Nigeria; Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Universit
Objective: To study the adherence levels and explore factors impacting them in out-patients on antiretroviral therapy (ART) at the AIDS Prevention Initiative in Nigeria antiretroviral clinic of the Jos University Teaching Hospital. Materials and Methods: We administered a structured questionnaire to 461 patientspresenting to the clinic. Adherence was measured using the patient self-report. The association between independent variables and adherence to ART was measured through odd ratios (OR) in the univariate analysis. The best predictors of adherence were determined through multiple logistic regression models with backward elimination. Results: The adherence level was found to be 87.9%. The following factors were found to have strong impact on adherence in the univariate analysis: age (OR 1.04), sex (OR 1.14), employment (OR 1.29), knowledge of HIV (OR 1.11), thrice daily frequency of drug intake (OR 1.68), twice daily frequency (OR 2.18), alcohol nonintake (OR 0.29), knowledge of ARVs (OR 1.23), pill burden (OR 1.20), and HIV status disclosure (OR 1.08). In the multivariate analysis, only age, alcohol nonintake and twice daily, frequency of drug intake affected adherence (P < 0.05). Conclusions: To increase adherence and the effectiveness of ART, there is need to continuously emphasize the use of adherence devices and reminders. Counseling and adherence education should also be emphasized especially for younger patients and those with low educational levels.
antiretrovirus agent; acquired immune deficiency syndrome; adult; alcohol consumption; article; controlled study; employment; female; human; Human immunodeficiency virus infection; knowledge; major clinical study; male; Nigeria; patient attitude; patient compliance; pill; prediction; prospective study; self report; structured questionnaire; tertiary health care; university hospital