Date of Award

12-2022

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

DR. MUHAMMAD ASHAR MALIK

Second Advisor

DR. NARJIS RIZVI

Third Advisor

Dr. Muhammad Imran Usmani

Department

Community Health Sciences

Abstract

Introduction: Nonadherence is a complex or multidimensional healthcare problem and remains a significant unmet challenge for optimizing patient outcomes. Significant proportions of patients do not receive the full benefit of their prescription as a result of non-adherence due to unaffordability, which raises morbidity and mortality rates as well as societal expenses. The study aimed to find the medication non-adherence of prescription medicine due to unaffordability in the most vulnerable population of Lyari.
Objective: To explore the effect of unaffordability on Medication Non-adherence in peri-urban areas of Karachi, Pakistan.
Methods: A cross-sectional study was conducted, and 542 patients were recruited, buying prescription medicine from the selected pharmacies in the peri-urban area (Lyari) Karachi. In addition, the snap of the recruited patient's prescription was taken with the receipt of the pharmacy bill. In[1]person interviews were done, and patients were asked questions about their sociodemographic history, illness status, duration of illness, and attendant relation with the patient. At the end of the interview, the reason for not buying the medicine as recommended by the doctor was asked of the patient.
Results: Our results showed that out of the total sample (n=542), 29% (have adhered to their prescription medicine as recommended by the doctor, and 71% have non-adhered to the prescription medicine. Among non-adhered, 48% of patients were non-adhered due to behavioral factors and, 46% of patients were non-adhered because of the financial factor. The Median cost of prescription medicines and dispensed medicines were PKR.444 and PKR.246, respectively (differencePKR.190). The difference in costs (PKR) among adhered and non-adhered was statistically significant.
Conclusion: Financial factors as a significant contributor to medicine non-adherence indicate the unaffordability of medicines by the majority of the population. This hints at the issues in prescription practices and medicine pricing regulation. We suggest more rigorous treatment of the subject matter for future studies by addressing other contributing factors such as therapy-related factors, physician-patient relations and unregulated prices of the medicines.

First Page

1

Last Page

35

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