Factors influencing compliance to treatment among people with chronic illness in an urban area of south india

Abstract

Introduction -From being predominant as the leading causes of morbidity and mortality communicable diseases are now being replaced by chronic non-communicable diseases as the major causes of public health concern. By the year 2020, 80% of the disease burden in the developing countries of the world is expected to come from chronic conditions. Compounding the problem is the fact that adherence to therapies for chronic conditions can be as low as 20%. This results in poor health outcomes at a very high cost to society, governments, and families. Methods- A cross sectional community based study was conducted in the urban field practice area of M S Ramaiah Medical College using modified cluster sampling technique. All persons who were ill or on long term medication or were hospitalized for a period more than three weeks in the last one year were interviewed. A semi-structured pre-tested questionnaire which contained questions regarding duration of treatment ,regularity of treatment and reasons for irregularity/stopping of treatment was used for the purpose of collection of data which was carried out by interview method by house-to-house visits Results -Prevalence of chronic illness was highest in the age group of >60 with 46.6% followed by 46-60 age group with a prevalence of 31.4%. . The mean duration of illness was 58.44 months and mean duration of treatment was 54.58 months. (table 1) . In the study population 60.4 % were regular with their treatment . Regularity of treatment was significantly associated with social class , literacy level. and occupation.Symptomatic improvement was the most common reason (18.8%) for irregularity or stopping of treatment followed by cost considerations (11.5%). Multivariate analysis of 32 variables included in the study showed association of regularity of treatment with sex, social class and family income. Conclusion -Role of socio-demographic factors in ensuring treatment compliance as found in the present study calls for involvement of families of people suffering from chronic illnesses in ensuring compliance to treatment.