Knowledge and attitudes of HIV-infected patients on antiretroviral therapy regarding adverse drug reactions (ADRs) in selected hospitals in Nigeria

Abstract

Purpose:The study evaluated the knowledge and attitudes of HIV-infected patients on ART regarding ADRs following routine patient counseling and education in selected hospitals in Nigeria.Materials and Methods:From 36,459 HIV-infected patients on ART in the 36 selected hospitals, a study-specific instrument was administered to 3,650 patients in a cross-sectional study. Patients were provided counseling and education on ADRs before and after commencing ART. Factor analysis was performed using principal components extraction. Item score means above midpoint (3.7) on a 5-point scale were regarded as positive attitudes and below as negative attitudes. A chi-square test was used for inferential statistics; P<0.05 was used to determine statistical significance.Results:The mean questionnaire return rate was 47.5%. Data from 2329 (63.8%) participants were analyzed, 63.1% females and 34.4% aged 25-34 years old. A total of 80.1% participants accepted to have been counseled on ADRs; 65.8% knew that all medicines cause some kind of adverse effects; 55.1% knew the adverse effects of their medicines; 60.8% knew what to do when they suspect ADRs and it included mainly reporting to the healthcare provider (88.1%). However, only 31.9% had experienced ADRs previously. The knowledge of ADRs was associated with gender and educational and employment status of the patients (P<0.05). A total of 95.6% reported self-efficacy to ART. Majority of the rated attitude score means were >3.7 which denotes positive attitudes to ADRs. Three extracted factors accounted for 73.1% of cumulative variability. All attitude items had very significant loadings of ≥0.5.Conclusion:Overall, participants reported good knowledge and positive attitudes to adverse effects of their medicines compared to what was reported previously. The patient counseling and education on drug therapy provided to patients may have contributed to these findings and are highly recommended.

Knowledge and Attitudes of HIV Infected Patients on the Adverse Effects of Antiretroviral Medicines in Ghana

“…This is contrary to a study reported by Agu et al in 2012 which found that knowledge of AEs was associated with female gender, self-employment status and older age [21]. This might be due to the low numbers in our sample size as compared with the multi-centre approach incorporating over 2329 patients from 36 public hospitals reported by Agu et al [21]. Out of 98 participants, 80 (82%) were willing to report their AEs to their healthcare provider in the hospital, but 6 (6%) indicated they will take another drug to treat suspected AEs on their own as against 5 (5%) who preferred to relax and do nothing.…”

“…All the measured socio-demographic characteristics of the study participants were found not to be associated with knowledge of AEs. This is contrary to a study reported by Agu et al in 2012 which found that knowledge of AEs was associated with female gender, self-employment status and older age [21]. This might be due to the low numbers in our sample size as compared with the multi-centre approach incorporating over 2329 patients from 36 public hospitals reported by Agu et al [21].…”

“…An average midpoint for all the six questionnaire items (on attitude to adverse effects of HIV medicines) was calculated as the sum of the rated score means calculated divided by the six questionnaire items. Individual questionnaire items with rated score means above the average midpoint were regarded as positive attitudes while below the mid-point were considered as negative attitudes [21]. To confirm whether the questionnaire items generated responses associated to other constructs that could not be directly measured; we conducted a confirmatory factor analysis, a data reduction tool which removes duplication from a set of correlated variables.…”

“…A study in Nigeria [21] reported good knowledge of AEs and positive attitudes, whereas another study [10] reported significant deficits in patients' knowledge leading to poor attitudes culminating in discontinuation of therapy. Another study in Nigeria concluded that respondents with good knowledge about the AEs of ARTs present positive attitudes, which results in better adherence to ART than those with poor knowledge [22].…”

“…The present study therefore is aimed at improving patient care by investigating the level of knowledge, the attitudes and practices of these patients with a view to identify any gaps in their knowledge which could be affecting their behaviours. We adopted a similar approach to the study carried out in Nigeria [21] but emphasized on three different components of attitude namely affective, behavioural and cognitive. We used factor analysis to help identify and differentiate these components.…”