[Adherence to therapy in sub-Saharan non-dialysed patients with chronic kidney diseases].
BACKGROUND
Poor adherence to medication regimens accounts for substantial morbidity, mortality and increased health care costs in developing countries. The aim of this study is to assess adherence to therapy in patients with chronic kidney diseases and to identify the major barriers to adherence.


METHODS
A prospective study of non-dialysed patients with chronic kidney diseases followed during three months. Sociodemographic, clinical and therapeutic data were collected from medical records and patient interviews. Rate of adherence (ROA) was defined as the percentage of the prescribed doses of the medication actually taken by the patient over a four-week period. Statistical analysis was done with SPSS 11.0.


RESULTS
Mean age of the 118 included patients was 39.28 years +/-16.4 (range 13-76 years); they were 56% female and one third had low instruction level. Socio-economic level was low for 38.5% of patients. Mean ROA was 81+/-12% (range 46 to 100%) but there was a difference between male (75%) and female (84%). Almost three quarters of patients (71%) had ROA more than 80%. Patients' adherence was inversely correlated to daily frequency of dose but not number of drugs. Major obstacles to adherence were complexity of drug regimen, forgetfulness, healthcare system inaccessibility, lack of information, side effects, automedication with phytotherapy and high cost of medications.


CONCLUSIONS
Most of barriers to adherence can be overcome by improving communication between patients, health provider and healthcare system.
Seck
Sidy Mohamed
SM
Service de médecine interne et nephrologie, CHU Aristide-Le-Dantec, 20, avenue Pasteur, B.P. 3001, Dakar, Sénégal. sidymseck@yahoo.fr
Elhadj
Fary Ka
FK
Fall
Seynabou
S
Cissé
Mouhamadou Moustapha
MM
Dia
Daouda
D
Guèye
Serigne
S
Pouye
Abdoulaye
A
Niang
Abdou
A
Diouf
Boucar
B
D017954:Africa South of the Sahara; D002908:Chronic Disease; D003142:Communication; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000523:psychology* / Q000628:therapy*; D008297:Male; D010349:Patient Compliance; D011369:Professional-Patient Relations; D011446:Prospective Studies; D012675:Senegal; D012959:Socioeconomic Factors