Assessment of factors affecting adherence to chronic medicines among stable patients registered onto the Centralized Chronic Medicines Dispensing and Distribution (CCMDD) programme: the case of eThekwini Metropolitan Health District, South Africa.

Abstract

Background Globally more deaths are due to chronic disease compared to infectious disease. In South Africa, the number of patients has been increasing over the years for those who have been diagnosed with chronic diseases and thus requiring chronic treatment. The Centralized Chronic Medicine Dispensing and Distribution (CCMDD) programme is a national programme with the aim to improve patients access to medicines in the public health sector. To establish the implications of factors that affect patient adherence to chronic medication on the CCMDD programme in eThekwini Metropolitan Health district. Methods A descriptive cross-sectional study was conducted among stable chronic patients on the CCMDD programme in five public health facilities in eThekwini Metropolitan Health District South Africa between May and August 2017. The researcher administered face-to-face interviews were carried out using a semi-structured questionnaire with open and closed-ended questions. Results Most patients reported never experiencing out of stock of medicines at PUPs (365/417, 87 .5%, 95%CI [84.1-90.5]) and never received an incomplete parcel (324/417, 77.7%, 95%CI [73.7-81.7]). Many respondents rated their relationship with CCMDD as good (221/417, 53.0%, 95%CI [48.12-57.79]); they were satisfied to collect their medicines without counselling at PUPs (411/417, 98.6%, 95%CI [97.47-99.73]) and rarely experienced challenges with the CCMDD programme (345/417, 82.7%, 95%CI [79.07-86.33]). Majority ofrespondents reported a waiting time less than 30 minutes (411/417, 98.6%, 95%CI [97.47-99.3]) after CCMDD programme implementation compared to two hours (398/417, 95.4%, 95%CI [93.39-97.41]) before CCMDD program implementation. Most respondents (370/417, 88.7%, 95%CI [85.66-91.74]) reported not missing their appointment for collection of their medicines. Conclusion Most respondents reported neither experiencing medicine stock-outs nor receiving incomplete medicine parcels, they had a good relationship with the CCMDD programme, were satisfied with no counselling at the PUPs and rarely experienced challenges. Majority respondents reported a significant decrease in the waiting time for the collection of their medicines after CCMDD programme implementation. Missed appointments for collection of medicine parcels were significantly low among study participants. These findings can suggest high levels of adherence to such a programme.