Adherence to Medication and Factors Contributing to Non-Adherence among Systemic Lupus Erythematosus (SLE) Patients in Outpatient Department at Kolkata

Background: Systemic lupus erythematosus is a chronic autoimmune disease that requires long term medication. Poor adherence to medication can lead to adverse outcomes, including frequent hospitalizations which further leads to increased health care cost. Due to the chronic nature of this disease, non-adherence to medication regimen has significant morbidity, mortality and considerable adverse effects among patients. In a view, the study was aimed to evaluate medication adherence of the patients periodically and to identify contributing factors related to non-adherence among SLE patient attending out-patient department of selected hospital, Kolkata. Material and Methods: A descriptive survey research design was adopted to find out assessment of adherence to medication and factors related to non-adherence to medication among patients with SLE attending out-patient department of selected hospital, Kolkata. The conceptual framework was based on Rosen stock?s Becker and Mauman?s Health belief Model. The non-probability purposive sampling technique was used to select 104 respondents. An un-structured interview schedule for demographic characteristics, standardized Morisky Medication Adherence Scale 8-item to assess adherence level and structured interview schedule for factors contributing to non-adherence was used to collect the data. The descriptive statistics were used to analyze the data based on objectives of the study. Result: The study findings showed that 73.07% respondents had poor adherence,26.92% respondents had medium adherence while no respondents had good adherence to medication. With mean percentage of 88%, factors related to medicines stands out as the most important contributing factor of non-adherence. The most common reason were feeling fatigue to take medicine regularly (74.03%), believe on bad luck or karma (61.53%), unavailability of free medicines (82.69%), too many medicines per day (82.69%), could not come to hospital alone(77.88%), cost of medication(83.65%), distance between home and hospital(88.46%) which were cited as most contributing reason for non-adherence of respondents. The analysis showed that there was statistically significant association between adherence to medication with occupation, duration of illness (in years), duration of taking medicines (in years) at 0.05 level of significance. Conclusion: The study had important implication in various field of nursing education, administration and research which paves the way for further research. The study was concluded with the recommendation to find out the effect of interventional protocol to enhance medication adherence among SLE patients.