Socioeconomic Determinants Affecting Compliance to therapy in Patients with Congenital Hypothyroidism in Sharkia Governorate

Abstract

Background: Congenital hypothyroidism (CH) is the most common preventable causes of mental retardation in children thus compliance to medication is known to improve the neurodevelopmental outcomes. Compliance to therapy can be affected by multiple factors. Objectives: The study aimed to explore compliance of the patients' guardian to medical therapy and to explore the socioeconomic factors affecting compliance to medication in patients with CH. Methods: A cohort follow-up study was conducted in Endocrinology and Pediatric Outpatient Clinics in Sharkia Governorate health insurance center. The study participants were 120 newborn and infant with CH. Data were collected using multi-structured questionnaires for determining socioeconomic state and Morisky Medication Adherence Scale (MMAS 8) to assess patient compliance. The results of investigations at diagnosis (initial TSH and T4) and during the follow-up visits were reviewed. Results: About two third of patient families were highly compliant to therapy. Compliance to therapy was affected by the occupational and educational levels of the parents as well as residence, income, social class of the parents and presence of symptoms and associated congenital anomalies. But the most significant factors affecting compliance to therapy were mother's education, social class, and the presence of symptoms at presentation.Conclusion: Compliance with L-thyroxin therapy in our patients and/or their family was found to be reasonable. The most significant factors affecting the compliance were mother's education, social class, and the presence of symptoms at presentation.