Care Management: Adherence to Therapies Among Patients at Bu-Alicina Clinic, Qazvin, Iran.

Background: non-adherence to treatment is a problem of increasing concern for all stakeholders. this study was designed to determine the prevalence of non-adherence among the clients consulting internists or cardiologists at bu-alicina clinic in qazvin. methods: a total number of 400 clients came to bu-alicina clinic (center for internal medicine and cardiology) were randomly interviewed through a questionnaire during a two month period in 2003. self-administered methods were used if the clients applied. the data were interpreted using statistical methods.results: the clients were between 14 and 78 years old (33.7±8.5) and 57.5% of them were women and 42.5% were men. of total number, 30.7% were consulting for continuation of their therapies and of these clients, 41.5% had pooradherence to their current therapies. the more educated clients were 1.6 times (or=1.62; 95% ci=0.71, 3.74) likely tobe more adherent to the therapies.there was no significant difference between the internal diseases patients and cardiology patients in this regard (41.7%vs 40%). of the total number of 400 clients, 79.5% had history of consulting to medical clinics during the last three months and 37.4% of them had non-adherence to their past therapies. the more frequent factors were: forgetfulness (13.3%), not to be able to afford to pay for treatment costs (10.3%), disbelieve to the doctor and consulting another ones (8.4%), long distance (8.4%), feeling that it is not important to take medications (7.4%), side effects (7.4%), disbelieve to the diagnosis (7.1%), religious considerations (6.5%), and misunderstanding or lack of information about the prescription (5.8%). no significant difference was found between men and women on this aspect. conclusion: patients need advice, supported information from professionals about their health and therapies. certain studies must be done to determine the pitfalls and effective interventions address that barriers can be developed.