Appointment keeping for medical review among patients with selected chronic diseases in an urban area of Uganda

Abstract

IntroductionProper management of chronic diseases is important for prevention of disease complications and yet some patients miss appointments for medical review thereby missing the opportunity for proper monitoring of their disease conditions. There is limited information on missed appointments among chronic disease patients in resource limited settings. This study aimed to determine the prevalence of missed appointments for medical review and associated factors among chronic disease patients in an urban area of Uganda.MethodsPatients or caregivers of children with chronic diseases were identified as they bought medicines from a community pharmacy. They were visited at home to access their medical documents and those whose chronic disease status was ascertained were enrolled. The data was collected using: questionnaires, review of medical documents, and in-depth interviews with chronic disease patients.ResultsThe prevalence of missed appointments was 42% (95%CI = 35-49%). The factors associated with missed appointments were: monthly income ≤30US Dollars (OR = 2.56, CI = 1.25–5.26), affording less than half of prescribed drugs (OR = 3.92, CI = 1.64–9.40), not experiencing adverse events (OR = 2.66, CI = 1.26–5.61), not sure if treatment helps (OR = 2.84, CI = 1.047.77), not having a medicines administration schedule (OR = 6.77, CI = 2.11–21.68), and increasing number of drugs (OR = 0.72, CI = 0.53–0.98).ConclusionPatients missed appointments mainly due to: financial and health system barriers, conflicting commitments with appointments, and perceptions of the disease condition. Patients should be supported with accessible and affordable health services.

Association between attendance at outpatient follow-up appointments and blood pressure control among patients with hypertension

“…In line with the findings of a pervious study [46], we found significant positive correlation between the number of medications used and the regularity in treatment follow-up visits. A higher number of medications often means greater disease severity which could motivate patients to regularly attend their follow-up appointments.…”

“…Increased disease severity or the presence of other co-morbidities among old age patients may encourage elderly patients to regularly attend treatment follow-up appointments. However, some studies found negative correlation between age and regularity in treatment follow-up [46]. This negative correlation may be due to memory loss, non-availability of any caregiver or deteriorated health condition of the patient.…”

Missed medical appointment among hypertensive and diabetic outpatients in a tertiary healthcare facility in Ibadan, Nigeria

“…While a study done among patients with selected chronic diseases in Uganda had found no association [16]; another study done among an underserved population at a Federallyfunded community health center in Massachusetts [17] reported association. A study also reported higher rates of nonattendance among women, one suggesting that childrearing and family responsibilities may play a part in non-attendance [18].…”

The pandemic of COVID-19 decreased adherence to treatment among hypertension patients at Dr. Zainoel Abidin Hospital

“…Our finding is consistent with that of a previous research conducted in Uganda, which showed no significant association between distance to health facilities with patients' adherence to follow-up visits. The most common cited reasons of non-adherence among patients with chronic diseases were financial problems, inadequate health care systems, and poor communication between patients and healthcare workers (Kalyango et al, 2014).…”