Predictors of Medication-Non Adherence in Patients with Pulmonary Tuberculosis

Author: Sana Nisar

Supervisor: Rukhsana Kausar, PhD

Degree: MS

Year: 2014-2016

University: Institute of Applied Psychology, Punjab University, Lahore, Pakistan

Abstract

The present study aimed to investigate medication non-adherence and level of Information about TB in patients with pulmonary tuberculosis. It was hypothesized that: a) There is likely to be a relationship between attitudes towards medication, subjective norms, perceived behavioral control, level of information, satisfaction with medication, intention and medication adherence; b) Intentions to take Medicines is likely to mediate the relationship between attitudes towards medication, subjective norms, perceived behavioral control, level of information about TB, satisfaction with medication and medication adherence. The sample comprised of 147 patients with pulmonary TB recruited from Gulab Devi Chest Hospital, Lahore. The assessment measures i.e. demographic information questionnaire and clinical Performa. Theory of planned behavior questionnaire (Conner et al., 1998), Satisfaction with medication questionnaire (Ruiz, 2008), Medication Adherence Rating Scale (Thompson et al., 2000) were translated in Urdu language and used for assessment. TB Level of information questionnaire was developed for this study. Patients have poor level of information about modes of transmission, prevention, diagnosis and treatment and complications resulting due to discontinuation TB treatment and non-adherence. Distance to hospital, waiting time in hospital and attitude of doctors and staff negatively predict medication adherence. Follow-up patients are more adherent as compare to Defaulter, relapse, treatment failure and Multi-drug resistant TB. Regression mediation analysis shows that, attitudes towards medication and subjective norms are fully mediated by intentions in predicting medication adherence while level of information about TB and satisfaction with medication is partially mediated by intentions in predicting medication adherence, which represents that patients have favorable beliefs about taking medication, higher social pressure to take medication but have weaker intentions and lower perceptions of behavioral control over taking medication due to external factors. Findings of the present study can be used to inform health-care providers about factors influencing the medication adherence in patients. TB program needs to consider the favorable environment for the patients addressing, status of loss to follow-up, awareness of disease transmission and the beliefs of patients about taking medication regularly.

Keywords: Predictors of Medication-Non Adherence, Pulmonary Tuberculosis.

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Corresponding Address: Department of Applied Psychology, University of the Punjab, Lahore, Pakistan. Email: chairperson@appsy.pu.edu.pk, Phone: 92-42-9231245

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