Patient perspectives on medication self-management in rural Kenya: a cross-sectional survey

The presence of HIV, tuberculosis and non-communicable diseases result in a double burden of disease in the East African community. Most studies have focused on urban Nairobi and western Kenya, leading to a lack of information on rural regions that make up 75% of the population. This study determined baseline rates and barriers to medication self-management in rural Meru County.

A cross-sectional, descriptive community survey focused on Meru, Kenya.

Participants were surveyed at a local Kithoka dispensary and the government operated Meru Level 5 Hospital.

Seventy-five chronic illness patients between June 2016 and July 2016.

Twelve-question Measures of Drug Self-Management Scale (MeDS).

Baseline rates of medication self-management. A score of 10 or more defined 'adequate' medication drug self-management.

The average MeDS score was 8.16 ± 2.4, indicating inadequate medication self-management. There was no significant difference across age (P = 0.75), and between the scores of males and females (8.1 ± 2.4 and 8.2 ± 2.5, respectively, P = 0.89). Minor side effects and the idea that taking medicines disrupt life were highly associated with inadequate drug self-management (r = 0.58). Forgetfulness and non-adherence had the highest correlation (r = 0.64). Cost is a large barrier, with 64% agreeing that they have a hard time paying for their medicines.

All questions on the MeDS survey had statistically significant correlations with the overall score, while gender and age did not. The MeDS questionnaire showed to be an effective tool to evaluate risk of long-term non-adherence globally in rural populations.