Determinants of Non-adherence to Chemotherapy Among Patients With Breast Cancer at Kenyatta National Hospital

Abstract

Background: Breast cancer is the most common cancer and the most common cause of cancer death in women worldwide. It exerts a huge burden in form of significant physical, emotional and financial strain on individuals, families, communities and health systems across the globe. Optimal treatment adherence is a critical pillar for the attainment of WHO Global Breast Cancer Initiative of significantly reducing the global breast cancer mortality by 2040. However, attainment of this noble cause is threatened by pervasive non-adherence to chemotherapy among patients diagnosed with breast cancer world over. Objective: To assess the determinants of non-adherence to chemotherapy among breast cancer patients attending oncology clinic at Kenyatta National Hospital. Methods: This was a descriptive cross sectional study that was conducted among 60 adult patients diagnosed with breast cancer who were non-adherent to chemotherapy treatment at the oncology clinic of Kenyatta National Hospital. The study participants were selected using census method. An interviewer-administered questionnaire was used as the data collection instrument. The questionnaire contained questions elicit information on the research subject guided by the study objectives. The study tool was pre-tested at Kenyatta University Teaching and Referral Hospital, using 6 questionnaires. The study data was analyzed through descriptive statistics using the Statistical Package for Social Sciences (SPSS, version 25) and presented through percentages and frequencies. Association between the study’s independent and dependent variables were evaluated using the chi-square test at 95% confidence interval. Result: Findings on patient related determinants; age (χ2= 5.583; p<.05), gender(χ2= 0.136; p<.05), education level(χ2= 3.148; p<.05), mode of administration (χ2= 51.00; p<.05), inaccessibility to cancer treatment (χ2= 23.528; p<.05) and availability of medications have significant association with non-adherence to chemotherapy treatment (χ2= 27.824; p<.05). Conclusion: The current study concluded that age, gender, education, mode of administration, inaccessibility to cancer treatment and availability of medications have significant association with non-adherence to chemotherapy treatment. Recommendation: Proper health education on chemotherapy non-adherence among age groups and level of education, hospitals should stock enough chemotherapy medications and more cancer centers should be set at county levels and properly equipped and staffed.