title: [Adherence to therapy in sub-Saharan non-dialysed patients with chronic kidney diseases].
abstract: 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.
authors.affiliation: Service de médecine interne et nephrologie, CHU Aristide-Le-Dantec, 20, avenue Pasteur, B.P. 3001, Dakar, Sénégal. sidymseck@yahoo.fr
authors.forename: Sidy Mohamed
authors.initials: SM
authors.lastname: Seck
authors.forename: Fary Ka
authors.initials: FK
authors.lastname: Elhadj
authors.forename: Seynabou
authors.initials: S
authors.lastname: Fall
authors.forename: Mouhamadou Moustapha
authors.initials: MM
authors.lastname: Cissé
authors.forename: Daouda
authors.initials: D
authors.lastname: Dia
authors.forename: Serigne
authors.initials: S
authors.lastname: Guèye
authors.forename: Abdoulaye
authors.initials: A
authors.lastname: Pouye
authors.forename: Abdou
authors.initials: A
authors.lastname: Niang
authors.forename: Boucar
authors.initials: B
authors.lastname: Diouf
mesh_terms: 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