Abstract
BackgroundThere is strong evidence that anti‐platelet therapy, ACE inhibitors, beta‐blockers and statins are cost‐effective in reducing subsequent cardiovascular disease (CVD) events in patients with atherosclerotic cardiovascular disease (ACVD). In some settings, only a low proportion of people have access to these medications, and even lower adhere to them. The current study explored and presents data on the causes of poor adherence to orthodox medication and motivations for alternative therapies in patients with established atherosclerotic cardiovascular disease (ACVD).MethodsThe study was conducted among city‐dwelling adults with ACVD in Accra – Ghana's capital city. Eighteen interviews were conducted with patients with established ACVD. A follow‐up focus group discussion was conducted with some of them. The protocol was approved by two ethics review committees based in Ghana and in the United Kingdom. All participants were interviewed after informed consent. Analysis was done with the Nvivo qualitative data analysis software.ResultsWe identified motivations for use of alternatives to orthodox therapies. These cover the five dimensions of adherence: social and economic, health‐care system, condition‐related, therapy‐related, and patient‐related dimensions. Perceived inability of an orthodox medication to provide immediate benefit is an important motivator for use of alternative forms of medication.ConclusionsA multiplicity of factors precipitate non‐adherence to orthodox therapies. Perceived efficacy and easy access to local alternative therapies such as herbal and faith‐based therapies are important motivators.
Highlights
Every year, over 30 million people experience acute coronary event or stroke; one-quarter of these events occur in people with established atherosclerotic cardiovascular disease (ACVD).[1]
This study was conducted in the Greater Accra Region of Ghana among patients diagnosed of ACVD and receiving treatment at the Police Hospital, Accra
Non-adherence to medication among patients with chronic ailments is a widespread practice in Ghana.[25,47,50]
Summary
Over 30 million people experience acute coronary event or stroke; one-quarter of these events occur in people with established atherosclerotic cardiovascular disease (ACVD).[1] ACVD includes two major conditions: ischaemic heart disease (IHD) and cerebrovascular disease (mainly ischaemic stroke) These conditions accounted for a combined 15.2 million deaths worldwide in the year 2016 and are the first and second causes of death worldwide.[2] By 2030, more than 23.3 million people are expected to die annually from cardiovascular diseases (CVDs).[2]. The current study explored and presents data on the causes of poor adherence to orthodox medication and motivations for alternative therapies in patients with established atherosclerotic cardiovascular disease (ACVD).
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