A0856 Compliance to Follow Up and Adherence to Medication in Hypertensive Patients in an Urban Informal Settlement in Kenya

Objectives: Adherence to treatment is a worldwide concern, compounded in slums where meeting basic needs supersedes care needs. This study seeks to determine and compare, among three models of care, compliance to scheduled clinic appointments and adherence to anti-hypertensive medication among patients with hypertension in an informal settlement (Kibera, Kenya). Methods: Routinely-collected patient data was used from three health facilities, six walkway clinics and one weekend/church clinic. Patients were eligible if they had received hypertension care for more than six months. Compliance with clinic appointments and self-reported adherence to medication were determined from clinic records and compared using the Chi-square test. Univariate and multivariate logistic regression models estimated the odds of overall adherence to medication. Results: There were 785 patients receiving hypertension treatment eligible for analysis, of whom, two-thirds were women. Between them, there were 5879 clinic visits with an overall compliance to appointments of 63%. Compliance was higher in the health facilities and walkways but men were more likely to attend the weekend/church clinics. Adherence to medication by those who complied with scheduled clinic visits was 94%. Patients in the walkway-clinics were two times more likely to adhere to anti-hypertensive medication compared to those at the health facility (OR 1.97, 95%CI 1.25–3.10). Conclusion: This study found that the walkway clinics outperformed the health facilities and weekend clinics. Also, the use of multiple sites for the management of hypertensive patients lead to good compliance with scheduled clinic visits and very good adherence to medication in a low resource setting.