Non-Adherence to Treatment Among Patients Attending a Public Primary Healthcare Setting in South Africa: Prevalence and Associated Factors

In underdeveloped nations, treatment non-adherence continues to be a significant barrier to effective disease management. It has a major impact on patients and healthcare systems in public primary healthcare settings. Patients who do not take their medications as prescribed may be at higher risk for negative health consequences. Polypharmacy, side-effects, and drug-related problems are factors contributing to non-adherence. Additional patient-related issues include multimorbidity, lack of support, chronic-drugs, and health-literacy. The purpose of this study was to ascertain the prevalence and contributing factors of treatment non-adherence among patients presenting to a public primary healthcare setting in South Africa. Between September and October 2014, cross-sectional quantitative research using structured questionnaires was carried out with one hundred patients who were chosen using random sampling. Self-reports from patients were used to assess non-adherence to therapy. A standardized questionnaire administered by the interviewer was used to gather data, and IBM SPSS version 29 was used for analysis. Patients aged 18 years and older who were using prescribed medications were included. The characteristics of the participants were obtained using descriptive statistics, and 95% confidence intervals (CIs) are reported for Odds ratios (ORs). Associations between related factors and treatment non-adherence were obtained using the Pearson Chi-square test; a <i>p</i>-value of less than 0.05 was deemed statistically significant. Of the 100 patients interviewed, 35% were men and 65% women. The majority were in the age-range of 60-80 years with a high school level of education. Demographic characteristics associated with non-adherence to treatment were gender (<i>p</i> = 0.03) and age (<i>p</i> = 0.03). Chronic conditions, alcohol consumption, recreational drug use, use of medication reminders, waiting time to get treatment and support from healthcare providers all were statistically significant with <i>p</i>-values < 0.001, time to get to the clinic (<i>p</i> = 0.02), mode of transport (<i>p</i> = 0.01), alcohol consumption (OR 22.25 [95% CI: 8.539-57.977], <i>p</i> < 0.001) and recreational drug use (OR 8.73 [95% CI: 5.01-15.98], <i>p</i> < 0.001) were also examined. Patient medication non-adherence is a major medical problem globally. Though patient education is the key to improving compliance, use of compliance aids, proper motivation, and support are also shown to increase medication adherence.