The effect of accessibility to drugs on outcome of therapy in patients with malignant lymphoma.
OBJECTIVE
To determine the compliance rate, reasons for default and factors affecting compliance.


METHODS
A prospective study of patients with malignant lymphoma (ML) at the University of Benin Teaching Hospital, Benin City, Nigeria. A total of 190 patients on chemotherapy for ML were followed up for between 6 and 18 months during study period (1995-2003). The reasons for default were recorded. Compliant and noncompliant patients were compared in terms of survival and sociodemographic data.


METHODS
Instat Package system for frequency counts, chi-squares and cross tabulations using Yates correction when necessary and the Fisher's exact test.


RESULTS
Noncompliance rate was 63.2%. Major reasons for defaulting were high cost of drugs in 40 cases (33.3%), scarcity of drugs in 29 cases (24.2%) and side effects in 24 cases (20.6%). Compliance was significantly associated with higher levels of education, socioeconomic status, geographical abode (P<0.001) and gender (P= 0.031). Survival was found to be significantly associated with compliance in non-Hodgkin's lymphoma (NHL) (P>0.001) while the relative risk (RR) was below unity in ML.


CONCLUSIONS
The level of compliance with medical therapy is still very poor. Health education and the provision of affordable, accessible and appropriate medical therapy are required. A multidisciplinary approach to improve compliance of patients with medical therapy is advocated.
Emoti
C E
CE
Department of Haematology University of Benin Teaching Hospital P.M.B. 1111, Benin City, Nigeria. ediomoti@yahoo.com
Enosolease
M E
ME
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use*; D005260:Female; D054625:Healthcare Disparities; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012959:Socioeconomic Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D016312:Treatment Refusal / Q000706:statistics & numerical data
D000970:Antineoplastic Agents