Predictors of anti-glycaemic medication-taking among adults with diabetes mellitus seeking care in a tertiary hospital in Cape Coast, Ghana

Objectives: This study sought to assess the level of anti-glycaemic medication-taking and its predictors among adults living with diabetes receiving treatment at Cape Coast Teaching Hospital (CCTH). Design: This was a cross-sectional study carried out among adults living with diabetes and receiving care at CCTH. Data on socio-demographic characteristics and anti-glycaemic medication-taking were gathered using a structured questionnaire. A scale consisting of 4 domains (filling prescribed medication; taking medications appropriately according to the instructions of healthcare professionals; practising behavioural modifications and showing up for follow-up appointments) and eight items was used to measure the level of anti-glycaemic medication-taking. Descriptive statistics, chi-square test (and Fisher's exact test where appropriate), bivariate and multivariate logistic regression models were used in analysing the data. Setting: The study was carried out in the diabetes clinic in Cape Coast Teaching Hospital. Participants: The total enumerative sampling technique was used to select 250 adults living with diabetes and receiving care at CCTH. Main outcome measures: Anti-glycaemic medication-taking Results: Out of 250 participants studied, 42% had high anti-glycaemic medication-taking. Predictors of anti-glycaemic medication-taking included forgetfulness (aOR=0.02, 95% CI: 0.00-0.64, p<0.001), patient's involvement in treatment plan (aOR=0.12, 95% CI: 0.02-0.64, p=0.014) and having good knowledge about one's medication (aOR=2.34, 95% CI: 1.10-4.98, p=0.028). Conclusion: Less than half of the sample population (42%) had high anti-glycaemic medication-taking, with forgetfulness, involvement in the treatment plan and good knowledge about anti-glycaemic medications, predicting medication-taking

Clinical trials in Ghana: evolution and current landscape.

A review of published clinical trials from Ghana shows the earliest trials initiated in the 1970s, were mainly trials of interventions against onchocerciasis and childhood Burkitt’s lymphoma. Subsequent trials in the 1980s and 1990s were more diverse, comprising of preventive as well as therapeutic interventions against major communicable diseases of the period. In more recent times, trials of interventions against malaria have since 2000, been the most dominant and have included some of the most recently developed vaccines. There has, since the early days of clinical trial history in Ghana, been a consistent presence of trials of reproductive health interventions and surgically-related trials. There have been few trials of tuberculosis, or neonatal-related interventions, and trials against major non-communicable diseases such as hypertension, cardiovascular diseases, and mental health disorders have been virtually non-existent. The clinical trial evolution in Ghana has reflected global health initiatives and external funding exigencies and there is an urgent need for trials that are dynamic and directed towards addressing other significant and especially non-communicable disease causes of morbidity and mortality in Ghana.

Adherence to Behavioral Symptoms Therapy for Uncomplicated Malaria in Rural Ghana: A Randomised Trial of Supervised Versus Unsupervised Drug Administration

Introduction.To enhance effective treatment; african nations including Ghana changed its malaria treatment policy from monotherapy to combination treatment with artesunate-amodiaquine (AS+AQ). The major challenge to its use in loose form is adherence. Objective. The objectives of this study were to investigate adherence and treatment outcome among patients treated with AS+AQ combination therapy for acute uncomplicated malaria. Methodology. The study was conducted in two rural districts located in the middle belt of Ghana using quantitative methods. Patients diagnosed with acute uncomplicated malaria as per the Ghana Ministry of Health malaria case definitions were randomly allocated to one of two groups. All patients in both groups were educated about the dose regimen of AS+AQ therapy and the need for adherence. Treatment with AS+AQ was supervised in one group while the other group was not supervised. Adherence was assessed by direct observation of the blister package of AS+AQ left on day 2. Results. 401 participants were randomized into the supervised (211) and unsupervised (190) groups. Compliance in both supervised (95.7) and unsupervised (92.6) groups were similar (P=.18). The commonest side-effects reported on day 2 among both groups were headaches; and body weakness. Parasite clearance by day 28 was 95in both groups. Discussion/Conclusions. Administration of AS-AQ in both groups resulted in high levels of adherence to treatment regimen among adolescent and adult population in central Ghana. It appears that high level of adherence to AS-AQ is achievable through a rigorous education programme during routine clinic visits