Assessment of factors that affects adherence to Antiretroviral therapy in Health institutions in Bayelsa State, South-South Nigeria

Abstract
Background: There is a huge cost burden in providing ARV Medicines. It is also important that patients get effective therapy, and the success of treatment is ensured. It is important to optimize the benefits of the limited available drugs to maintain the health of patients and get the maximal benefit of the regimen. Non-adherence ultimately leads to treatment failure. The objective of the study was to evaluate factors that affect adherence to antiretroviral therapy.

Methods: Prospective systematic review of ART clients. The study population consists of patients receiving ART treatment at Federal Medical Centre Yenagoa and Diete Koki (DK) Memorial Hospital Yenagoa. Data were generated from the patients using a well-structured questionnaire that met study objectives and a data collection form to get treatment information from the case file. Ethical approval was obtained as it applies to this study. Data were analyzed with the SPSS computer analytical tool, version 27.0.

Results: A total of 531 clients were accessed from two health institutions. Most of the clients are 31-45 years (41.4% FMC, 51.6% DK). More than half of the clients receiving cART were engaged in business or trading which accounted for 58.6% in FMC and 57.8% in DK hospital respectively. The majority had taken the drugs between 2 years and above 5 years (83.3%FMC, 60.2%DK). Most were on an ART regimen, taken once a day (87.3% FMC, 89.8%DK). The majority swallowed at most two tablets a day (40.7%FMC, 49.2%DK). Most had missed taking their medications once or twice a week (32.4% in FMC and 96.1% in DK). Some patients missed clinic visits about 5 times in the last year (25.6% FMC, 28.1% DK) some of them have experienced side effects that made them stop taking medication (11.4% FMC, 23.4% DK). The majority of the patients said they were not told what to do when they experienced these side effects (89.1% FMC, 81.3% DK) Factors that contributed or caused non-adherence to therapy includes poverty (a significant number of clients earned between N5000- N15000 per month (19.9% in FMC and 44.5% in DK hospital), high cost of transportation, missed clinic visits, inadequate counseling, lack of proper follow-up, inability to understand information, drug resistance and ADRs.

Conclusion: There is a significant level of non-adherence by clients in the study as observed in patients missing their medications, clinic visits, and outright stopping taking medication. Proper counseling and follow-up are needed.