Adherence of patients towards drugs and injections prescribed in a private medical institution in Chennai

INTRODUCTION

The irrational use of drugs has become a potential health hazard in the modern days of medicine. According to the WHO 50% of all medicines are prescribed, dispensed, or sold inappropriately.¹

Prescription of medicine is the heart of clinical practice. Another important and most preferred procedure in clinical practice is injection with an estimated administration of 16 billion every year worldwide.² In India curative injections are more popular than oral medications. Majority of patients tends to insist on injections when the self or oral medications fails to bring immediate relief. The prevalence of self-medication for minor ailments is also high worldwide which when goes unsupervised is a highly dangerous to the patients. Adherence to medication influences treatment outcome. Patient perceptions and education on medications are important determinants for a good adherence to prescribed drugs. Hence the present study intends to assess the knowledge and attitude of patients towards medications.

METHODS

The cross-sectional study was conducted in urban health training Centre of a private medical college in Chennai from January 2017 to February 2017. Taking the prevalence of injection preference as 63% and a non-response rate of 10% the required sample size arrived as 125.

The study included patients above 18 years of age attending urban health training centre OPD, patients who were seriously ill and not willing to participate were excluded from the study.

After obtaining written informed consent from the participants data was collected using a pretested semi structured questionnaire and information regarding socio-demographic factors like age, sex, education, occupation, patient’s perception about medications were obtained.

Statistical analysis was done using statistical software SPSS version 21. Outcome variables were expressed as mean, proportions. Chi-square test was used to calculate the significance ≤0.05 was considered as significance.

RESULTS

Out of 125 participants 66.4% were females and the mean age of the study population was 43 years.36.8% of the participants had completed education up to primary and 51% belonged to the upper socioeconomic class.

Table 2 shows that 78.4% of the participants consult a doctor for medical advice and 84% of the patients would take the medicine as prescribed by doctors. 45.6% of the participants got drugs from OTC, 44% of the patient use old prescription for similar complaint.

58.4% of the patient demanded for injection and 72% think injection is more powerful than oral drugs.

Knowledge of patients towards medications was good among highly educated participants when compared to those who had primary education and illiterates which was statistically significant with a p value of 0.02. Younger participants had a better knowledge on medication when compared to the elders and the difference was statistically significant (p=0.05).

DISCUSSION

The present cross-sectional study conducted in a private medical institute included 125 participants to assess the knowledge and attitude of patient towards medication showed poor attitude towards medications.

In the current study 78.4% of the participants told they would consult a doctor for medical advice whereas in a study conducted by Aishwarya et al 31% of the people would do the same.³ But 84% of participant would stop drugs once symptoms subside which is comparable to a study conducted by Rabbo et al where 70% discontinued the treatment once the symptoms subsided.⁴ This shows a poor adherence among the participants. Though the knowledge on medication was better among younger population and highly educated people only 36.8% of the patients are aware of the side effects of the prescribed drugs similar to a study by Rabbo et al where 26% are aware of the side effects of the drugs.⁴

Self-medication is a significant rising problem in the modern days of medicine which is evident in the present study where 45.6% told they would get drugs from OTC similar to a study Shankar et al where 58.1% followed self-medication.⁵ A study conducted by Kaushal showed a high prevalence of self-medication (70%).⁶ The lack of time and financial restrictions for frequent consultation would be the cause for the high prevalence of self-medication.

The attitude and knowledge towards injections was also poor among participants because 58.4% of the participants would demand for injections which is comparable to a study conducted by Shankar et al where 63% of the patient preferred injection.⁵ The preference of injection was high because rapid cure and cost effectiveness. A multidisciplinary approach must be used to promote rational use of medicine.⁷

CONCLUSION

The knowledge and attitude towards medication was poor in the present study which in turn led to poor adherence. Also, the prevalence of self-medication was high which may put patients at risk of health-related problems. Directing health education towards people would bring significant behavior changes and also policy makers should emphasize on the rational use of drugs by the patients.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

REFERENCES

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2. 2. Hutin YJ, Hauri AM, Armstrong GL. Use of injections in healthcare settings worldwide, 2000: Literature review and regional estimates. BMJ. 2003;327:1075.
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