Missed medical appointment among hypertensive and diabetic outpatients in a tertiary healthcare facility in Ibadan, Nigeria

Purpose: To explore the reasons for missed medical appointment, patients’ awareness on its consequences; and to find strategies to reduce it among the study population.Methods: This was a descriptive cross-sectional survey among 300 hypertensive and 200 diabetic outpatients assessing care at the University College Hospital, Ibadan. Descriptive statistics was used to summarize data and categorical variables were compared with Chi-square at a level of significance set at p ≤ 0.05.Results: For hypertensive respondents, 16.7 % missed > 30 % of scheduled medical appointments while for diabetic respondents, it was 13.0 %; 59.7 % of the hypertensive respondents and 63.5 % of the diabetic respondents adhered to their medications. The reasons for missed medical appointments include forgetfulness, lack of funds for transport, conflicting commitments, etc. The level of awareness on the possible impact of missed medical appointments is low. Most of the respondents were of the opinion that those who missed appointments should be penalized, although a majority of them disagreed with the option of introducing financial penalties.Conclusion: The findings indicate that the reasons for missed medical appointment is mainly due to delay in attending to un-booked patients until all the scheduled patients are seen in order to reduce appointment non-adherence.Keywords: Missed medical appointments, Hypertensive, Diabetic outpatients, Medication adherence, Patient awarenes

Social Support, Treatment Adherence and Outcome among Hypertensive and Type 2 Diabetes Patients in Ambulatory Care Settings in southwestern Nigeria

Objectives: To evaluate available and desired sources and types of social-support among hypertensive and type-2- diabetes (T2D) patients. Associations of medication adherence and clinical outcome with access to most available social-support and medicine affordability were subsequently investigated.Design: Cross-sectional questionnaire-guided interview among 250-hypertensive and 200-T2D patients, and review of medical records to retrieve disease-specific clinical parameters.Settings: University College Hospital and Ring-Road State Hospital, Ibadan, southwestern Nigeria.Participants: Adults out-patients with hypertension, T2D, and T2D comorbid with hypertension were enrolled, while in-patients were excluded.Results: Family source of support was the most available [hypertensive (225; 90.0%); T2D (174; 87.0%)], but government and non-governmental organisation support were largely desired, with financial support preferred, 233(93.2%) hypertensive and 190(95.0%) T2D, respectively. Adherent hypertensive patients with or without access to family support were (127; 56.4%) versus (18; 72.0%), p=0.135; while for T2D were (103; 59.2%) versus (21;80.8%), p=0.035. Mean systolic blood pressure of hypertensive and fasting plasma glucose of T2D with access to family and financial support were better than their counterparts without access (p>0.05). Hypertensive (110; 76.4%) and T2D (87; 87.0%) participants who consistently afford medicine expenses had significantly better adherence and outcome (p<0.05).Conclusions: Family source of support is the most accessible, but government and non-governmental organisation support were largely desired. Access to family support did not positively influence medication adherence, while access to financial support marginally impacted on outcome among hypertensive and T2D patients. However, unwaveringtendency for therapy affordability significantly influenced adherence and outcome, thus, the need for expanded social-support system in order to consistently ensure improved outcome.Funding: None declaredKeywords: Social support system, Type 2 diabetes, Hypertension, Treatment adherence and outcome, Out-patient