Adherence to routinely prescribed medications among paediatric sickle cell disease patients in Kumasi, Ghana

Objective: To measure the adherence to routinely prescribed medications among Sickle Cell Disease (SCD) patients in Kumasi, GhanaDesign: A cohort study involving paediatric SCD patients presenting to the outpatient clinic at the Komfo Anokye Teaching Hospital (KATH).Setting: The Pediatric SCD Outpatient Clinic of KATH.Participants: Two hundred SCD patients visiting the outpatient clinicIntervention: NoneMain Outcome Measure: Cost and adherence to Penicillin V, Folic Acid, Hydroxyurea and Vitamins prescribed to SCD patients on routine outpatient visits.Results: Of the 200 participants, the highest and lowest phenotypes were Hb-SS (162, 80.1%) and Sβ-thal (3, 1.5%), respectively. The adherence rate to routine medications was 13.5% (95%CI: ut9.1% to 19.0%). Patient factors that affect adherence included forgetfulness 98(49%), cost 54(27%), and side effects 28(14%) of medication, and improvement in health 7(3.5%). Hydroxyurea was the costliest to the patients with a median (IQR) cost of GHc 75 (0, 450) or USD12 (0, 73), and the least was folic acid with a median of GHc 6 (0, 42) or USD 1 (0, 7). 44.5% of all medications prescribed were not obtained in full. 83% of those who did not purchase all the medicines attributed this to cost, with 13% indicating they had some at home.Conclusion: There is low adherence to routine medications used by SCD patients in Kumasi, and this could be because of their relatively high cost. Further studies should be made to assess the non-adherent effects of SCD medications on patients' health.