Non-attendance of treatment review visits among epileptic patients in Gokwe South district: Midlands province, Zimbabwe

Abstract

Epilepsy is the most common condition reported through the psychiatric returns surveillance system in Gokwe South District. The condition is controllable with antiepileptic medication. Review visits attendance is key to the successful control of seizures among epilepsy patients. A high proportion of scheduled review visits are missed every month. This study sought to establish the attendance pattern of epileptic patients, prevalence of non-attendance and the associated factors. Methods: The study was an analytic cross-sectional study. One hundred and ten (110) respondents were selected randomly from the district’ epilepsy register. Interviewer-administered pretested questionnaires were used to collect data. Epi info version 3.5.1 was used to create frequencies and proportions were calculated as well as Odds ratios to determine associations. Logistic regression analysis was done to identify independent risk factors and to control for confounding variables. Results: One hundred and ten (110) epileptic patients were included in the study. The epileptic patients missed treatment review visits ranging from 1 to 11 of the expected 12 review visits between June 2011 and June 2012. 70.9% missed at least 2 visits in a period of 12 months while 46.4%missed 2 or more consecutive visits. Knowledge of treatment duration [POR 0.24(95% CI 0.08-0.74)] and high risk perception [POR 0.14 (95% CI: 0.06-0.33) were associated with a lower likeliness of missing review visits. Barriers such as shortage of drugs [POR 7.09 (95% CI: 3.00-16.72)] and long distances to health facilities [POR 6.63(95% CI: 2.63-16.76)] were associated with high likeliness of missing two or more review visits consecutively. Shortage of drugs [AOR 6.7336 (95% CI: 1.8538, 24.4581)]and higher risk perception [AOR 0.1948(95% CI: 0.0625, 0.6071)] remained significant on logistic regression analysis. Conclusion and Recommendations A high number of epileptic patients miss their review visits mainly owing to shortage of drugs, having no village health workers to assist patients in treatment process. The District Health Executive must ensure constant supply of Antiepileptic drugs.