The Predictors of Medication Adherence among TB Patients on the E-Refill Prescription System in Health Care Facilities in Lagos State


Authors : Akinremi-Aina Titilope; Dangana Jonathan

Volume/Issue : Volume 9 - 2024, Issue 9 - September


Google Scholar : https://tinyurl.com/24ty26wb

Scribd : https://tinyurl.com/529t68vw

DOI : https://doi.org/10.38124/ijisrt/IJISRT24SEP576

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : Background: Tuberculosis (TB) has continued to be a major health concern to man and has affected majority of the population around the world. In the World Health Organisation (WHO)’s estimate, Nigeria is second in Africa and seventh in the world with regard to cases. Since Lagos is the most populous state in Nigeria, it has made a high number of tuberculosis cases. Since there is no cure for TB without taking the prescription drugs, noncompliance has been as frequent as the disease, leading to treatment failure, drug resistant TB and increased cost of healthcare. The e-refill prescription system which is an electronic prescription refill system is targeted to increase medical compliance amongst TB patients consequently improving overall health.  Aim: The purpose of this study is therefore to evaluate the factors which determine medication compliance among TB patients on the e-refill prescription in health facilities in Lagos state.  Setting: Various healthcare facilities across Lagos.  Methodology: This study employed the cross-sectional method. For sampling, we opted for a purposive sampling approach to select the patients. The sample size, determined using the Kish formula, comprised approximately 338 TB patients. In order to collect data on critical factors such as patient’s satisfaction, factors influencing e-refill medication adherence, and the willingness to adopt the e-refill system, this study made use of in-depth interview and semi- structured question. Furthermore, the collected data was analysed with SPSS software, with two team members independently coding the interview transcripts to identify emerging themes and resolve discrepancies through consensus discussions.  Results: A large proportion of the participants fell between the ages of 28 to 38 years (45.9%), (53.0%) were married, and the Yoruba ethnic group dominated the population at (49.4%). Most patients received care from government- owned facilities (75.1%). 68.6% considered medical adherence important. Of factors influencing medical adherence, (47%) said that forgetfulness often affected their adherence, and (23.7%) cited the side effect. Of those surveyed, 54.4% expressed interest in using the e- Refill system, and 60.7% were knowledgeable about it. Ease of use (32.8%) and system trust (29.9%) are the main variables influencing readiness to utilise the e-Refill system.  Conclusion: The e-Refill system has shown potential for success in improving medication adherence among TB patients in Lagos state. However, it is important to address challenges such as limited access to healthcare and reluctance among certain patient groups need to be addressed. To get maximum result possible from the system, it is important to take steps to enhance patient engagement, address stigma associated with the illness, and ensure sustained support over the duration of the treatment.  Contribution: The study highlights the significance of niche interventions geared towards promoting medication adherence and improving TB treatment outcomes in resource-constrained environments.

Keywords : Tuberculosis, e-Refill Prescription System, Medication Adherence.

References :

  1. Gopalaswamy R, Dusthackeer VNA, Kannayan S, Subbian S. Extrapulmonary Tuberculosis—An Update on the Diagnosis, Treatment and Drug Resistance. Journal of Respiration. 2021 May 26;1(2):141–64.
  2. World Health Organization. Global tuberculosis report 2020 [Internet]. www.who.int. 2020. Available from: https://www.who.int/publications/i/item/9789240013131
  3. Adepoju VA, Oladimeji KE, Adejumo OA, Adepoju OE, Adelekan A, Oladimeji O. Knowledge of International Standards for Tuberculosis Care among Private Non-NTP Providers in Lagos, Nigeria: A Cross-Sectional Study. Tropical Medicine and Infectious Disease. 2022 Aug 18;7(8):192.
  4. Koo HK, Min J, Kim HW, Lee J, Kim JS, Park JS, et al. Prediction of treatment failure and compliance in patients with tuberculosis. BMC Infectious Diseases [Internet]. 2020 Aug 24;20:622. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7446045/
  5. Vernon A, Fielding K, Savic R, Dodd L, Nahid P. The importance of adherence in tuberculosis treatment clinical trials and its relevance in explanatory and pragmatic trials. PLOS Medicine. 2019 Dec 10;16(12):e1002884.
  6. Bhargava A, Bhargava M, Juneja A. Social determinants of tuberculosis: context, framework, and the way forward to ending TB in India. Expert Review of Respiratory Medicine. 2020 Oct 20;15(7):1–17.
  7. Vejdani M, Varmaghani M, Meraji M, Jamali J, Hooshmand E, Vafaee-Najar A. Electronic prescription system requirements: a scoping review. BMC Medical Informatics and Decision Making. 2022 Sep 3;22(1).
  8. Sazali MF, Rahim SSSA, Mohammad AH, Kadir F, Payus AO, Avoi R, et al. Improving tuberculosis medication adherence: The potential of integrating digital technology and health belief model. Tuberculosis and Respiratory Diseases. 2022 Dec 23;86(2).
  9. Aremu TO, Oluwole OE, Adeyinka KO, Schommer JC. Medication adherence and compliance: Recipe for improving patient outcomes. Pharmacy. 2022 Aug 28;10(5).
  10. Mesa JM. Sampling: How to Select Participants in My Research study? Anais Brasileiros De Dermatologia [Internet]. 2016;91(3):326–30. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4938277/
  11. Koulayev S, Simeonova E, Skipper N. Can Physicians Affect Patient Adherence With Medication? Health Economics. 2016 Jun 16;26(6):779–94.
  12. Schultz WM, Kelli HM, Lisko JC, Varghese T, Shen J, Sandesara P, et al. Socioeconomic Status and Cardiovascular Outcomes: Challenges and Interventions. Circulation [Internet]. 2018;137(20):2166–78. Available from: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.029652
  13. Shah R, Shah A, Patel P, Thakker R. Stigma associated with tuberculosis - An Indian perspective. National Journal of Physiology, Pharmacy and Pharmacology. 2020;10(7):1.
  14. Barik AL, Indarwati R, Sulistiawati S. The Effectiveness Of Using Text Messages Reminder On Adherence With Tuberculosis Patients: A Systematic Review. STRADA Jurnal Ilmiah Kesehatan. 2020 Nov 1;9(2):751–60.
  15. Mohammed Malih Radhi, Shatha Mahmood Niazy, Sameeha Naser Abed. Individual-related factors associated treatment adherence among hypertensive patients. Journal of Public Health in Africa [Internet]. 2023 May 24;14(6). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10395365/
  16. Javed SA, Liu S, Mahmoudi A, Nawaz M. Patients’ satisfaction and public and private sectors’ health care service quality in Pakistan: Application of grey decision analysis approaches. The International Journal of Health Planning and Management. 2018 Aug 30;34(1).
  17. Pedersen CA, Schneider PJ, Scheckelhoff DJ. ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration—2014. American Journal of Health-System Pharmacy. 2015 Jul 1;72(13):1119–37.
  18. Nigussie S, Edessa D. The Extent and Reasons for Dissatisfaction From Outpatients Provided With Pharmacy Services at Two Public Hospitals in Eastern Ethiopia. Frontiers in Pharmacology [Internet]. 2018 Oct 12;9. Available from: https://www.frontiersin.org/articles/10.3389/fphar.2018.01132/full
  19. Gulumbe BH, Adesola RO. Revisiting the blind spot of substandard and fake drugs as drivers of antimicrobial resistance in LMICs. Annals of Medicine & Surgery. 2023 Feb;85(2):122–3.
  20. Taylor K, Singer S, May M, Gülsemin Durdu, Petermann‐Meyer A. Outcome comparison of integrated psycho‐oncological care versus unstructured care—Results of a non‐randomised open‐label two‐arm trial. European journal of cancer care. 2019 Jun 27;28(5).
  21. Ionescu SV. E-prescription using blockchain technology [Internet]. IEEE Xplore. 2022 [cited 2023 Feb 10]. p. 1–7. Available from: https://ieeexplore.ieee.org/document/10034520
  22. Hossain N, Yokota F, Sultana N, Ahmed A. Factors Influencing Rural End-Users’ Acceptance of e-Health in Developing Countries: A Study on Portable Health Clinic in Bangladesh. Telemedicine and e-Health. 2019 Mar;25(3):221–9.
  23. Annisa AT, Yasin NM, Kristina SA. THE ROLE OF THE E-PRESCRIBING SYSTEM IN HEALTHCARE: A SYSTEMATIC REVIEW. Jurnal Farmasi Sains dan Praktis [Internet]. 2023 Mar 25;9(1):40–8. Available from: http://journal.unimma.ac.id/index.php/pharmacy/article/view/8257
  24. Shadadeh F, Samadbeik M, Amiri F, Hajipourtalebi A. The Digital Gap in Patients’ Use of Health Information Technology and Effective Factors and Strategies; a Systematic Review. Health Research Journal. 2019 Jul 1;4(3):181–8.
  25. Sahi MA, Abbas H, Saleem K, Yang X, Derhab A, Orgun MA, et al. Privacy Preservation in e-Healthcare Environments: State of the Art and Future Directions. IEEE Access. 2018;6:464–78.

Background: Tuberculosis (TB) has continued to be a major health concern to man and has affected majority of the population around the world. In the World Health Organisation (WHO)’s estimate, Nigeria is second in Africa and seventh in the world with regard to cases. Since Lagos is the most populous state in Nigeria, it has made a high number of tuberculosis cases. Since there is no cure for TB without taking the prescription drugs, noncompliance has been as frequent as the disease, leading to treatment failure, drug resistant TB and increased cost of healthcare. The e-refill prescription system which is an electronic prescription refill system is targeted to increase medical compliance amongst TB patients consequently improving overall health.  Aim: The purpose of this study is therefore to evaluate the factors which determine medication compliance among TB patients on the e-refill prescription in health facilities in Lagos state.  Setting: Various healthcare facilities across Lagos.  Methodology: This study employed the cross-sectional method. For sampling, we opted for a purposive sampling approach to select the patients. The sample size, determined using the Kish formula, comprised approximately 338 TB patients. In order to collect data on critical factors such as patient’s satisfaction, factors influencing e-refill medication adherence, and the willingness to adopt the e-refill system, this study made use of in-depth interview and semi- structured question. Furthermore, the collected data was analysed with SPSS software, with two team members independently coding the interview transcripts to identify emerging themes and resolve discrepancies through consensus discussions.  Results: A large proportion of the participants fell between the ages of 28 to 38 years (45.9%), (53.0%) were married, and the Yoruba ethnic group dominated the population at (49.4%). Most patients received care from government- owned facilities (75.1%). 68.6% considered medical adherence important. Of factors influencing medical adherence, (47%) said that forgetfulness often affected their adherence, and (23.7%) cited the side effect. Of those surveyed, 54.4% expressed interest in using the e- Refill system, and 60.7% were knowledgeable about it. Ease of use (32.8%) and system trust (29.9%) are the main variables influencing readiness to utilise the e-Refill system.  Conclusion: The e-Refill system has shown potential for success in improving medication adherence among TB patients in Lagos state. However, it is important to address challenges such as limited access to healthcare and reluctance among certain patient groups need to be addressed. To get maximum result possible from the system, it is important to take steps to enhance patient engagement, address stigma associated with the illness, and ensure sustained support over the duration of the treatment.  Contribution: The study highlights the significance of niche interventions geared towards promoting medication adherence and improving TB treatment outcomes in resource-constrained environments.

Keywords : Tuberculosis, e-Refill Prescription System, Medication Adherence.

Never miss an update from Papermashup

Get notified about the latest tutorials and downloads.

Subscribe by Email

Get alerts directly into your inbox after each post and stay updated.
Subscribe
OR

Subscribe by RSS

Add our RSS to your feedreader to get regular updates from us.
Subscribe