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

Background: 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 health care 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 obstacles to medication non-adherence. Next are patient-related issues such multimorbidity, lack of support, chronic drugs, and health literacy. Age-related functional decline may also result in non-adherence. 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, despite the fact that non-adherence is a significant public health concern. No such study has been conducted in this context. Methods: Between September and October 2014, a cross-sectional quantitative research using structured-questionnaires was carried out with patients. One hundred individuals were chosen through the use of purposeful sampling. Self-reports from patients were used to gauge 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 who were using prescription or over-the-counter drugs and were at least 18 years old were included. The characteristics of the participants were described using descriptive statistics, and the frequencies and percentages of categorical variables were reported. Ratios of odds with 95% Binary variables were analyzed using confidence intervals, and the relationships between related factors and treatment non-adherence were examined using the Pearson Chi-square test; a p-value of less than 0.05 was deemed statistically significant. Findings: Of 100 patients aged 60–80 years, 35% were men and 65% were women, all having a high school diploma. Demographic characteristic associated to non-adherence to treatment were gender (p=0.028, age (p=0.030), chronic conditions (p< 0.001), time to the clinic (p=0.018), mode of transport (p=0.010), both alcohol and recreational drugs (p< 0.001), patient reminders (p< 0.001), waiting time to get treatment and treatment by healthcare providers (p< 0.001). Alcohol consumption (R (OR 22.25[95%CI: 8.54-57.98], p < 0.001) and Recreational drugs (OR 8.73[95%CI:5.01-15.98], p< 0.001).