Planned health care non-attendance and asthma control among asthma patients in real life setting in an African country: a prospective cohort study

Eric Walter Pefura Yone, André Pascal Kengne, Adamou Dodo Balkissou

Abstract


BACKGROUND: Compliance with scheduled medical visit is an indirect indicator of the adherence to treatment. The aim of this study was to determine the incidence of non-compliance with scheduled medical visits and investigate the predictors and relationship with disease control among patient with asthma in the sub-Saharan African setting.
METHODS: We conducted a prospective study between January 2012 and August 2013. All patients with asthma receiving care at the Yaounde Jamot Hospital and CEDIMER medical practice were included. Planned medical visit occurred at month one, three, six and twelve following baseline evaluation. Regression models were employed to investigate the predictors of non-compliance.
RESULTS: 186 patients [121 (65.1%) being female] were included. Their median age (25th-75th percentiles) was 35.5 (20.0-52.3) years. A total of 67 (36%) failed to attend at least one of the scheduled visits. The proportion of patients who failed to comply with scheduled visits was 48.4%, 68.8%, 73.5% and 79.5% at month one, three, six and twelve respectively. The accompanying rates of unacceptable asthma control were 17.2%, 24.4% and 20.8% respectively at three, six and twelve months of follow-up. Inadequate asthma control at baseline was the main predictor of non-compliance with medical visits, with adjusted odds ratio ranging from 2.00 to 4.67. Furthermore, non-sensitisation to non-pollinic aeroallergens was associated with 2.79 (95%CI 1.58-6.07) risk of non-compliance at one month of follow-up.
CONCLUSION: Targeting education of patients with poorly controlled disease at baseline can potentially improve adherence to medical visit and anti-asthmatic treatments and outcomes of care.


Keywords


asthma Cameroon

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