A community based study to assess the effect of community owned clinics on medication adherence among elderly patients with non communicable diseases in rural central India

With the double burden of diseases on the rise, particularly in LMICs, empowering the community with regard to primary health care related to Non-Communicable Diseases (NCDs) could be a game-changer. Thus, the department of Community Medicine from the institute worked with the community and together, they developed and established “Kiran Clinics”-community-owned primary healthcare clinics, in a few of the villages within the institution’s field practice area. To compare the medication adherence of elderly patients diagnosed with NCDs residing in the villages with and without Community Owned Clinics [COCs]. We conducted an analytical cross-sectional study of two months duration with 192 patients using simple random sampling, which compared medication adherence for NCDs (Hypertension and Diabetes Mellitus) from villages where COC was operational to those villages where COC was not established. We included participants with a minimum of one-year residency in the study. The survey questionnaire, inclusive of the Morisky Medication Adherence Scale-8 (MMAS-8), was employed to measure adherence to treatment, enriching the study’s depth on healthcare experiences. The study revealed a statistically significant difference between the medication adherence in the elderly patients of NCDs in COC and non-COC settings (p value:0.002). Logistic regression for medication adherence showed statistically significant impact of COC visits (aOR for COC Non visitors: 0.34 [CI 0.13,0.90] and aOR for Non-COCs: 0.36 [CI 0.14,0.92]) and employment status (aOR: 2.40 [CI 1.17,4.95]) of the elderly. The study underlines the importance of community-owned clinics in better medication adherence in elderly patients suffering from NCDs, highlighting the importance of community participation and ownership in primary health care.