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PART II. PATIENT-LEVEL GEOMETRY: ADHERENCE AND UNCERTAINTY—THE CHALLENGE OF PRACTICING CHANGE WHILE CHANGING PRACTICE

The STARK Study

A Cross-Sectional Study of Adherence to Short-Term Drug Regimens in Urban Kenya

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Pages 237-250 | Published online: 22 Sep 2008
 

Summary

The purpose of the STARK study (Short-Term Adherence Research in Kenya) was to identify factors that predict adherence to short-term drug regimens in Nairobi, Kenya. The participants (N = 357) in the study were recruited from the RAFIKI Foundation Clinic, a free primary healthcare clinic in Kibera, Nairobi's largest slum. Quantitative surveys were administered to all the participants regarding their adherence patterns and to a subgroup of mothers (N = 233) regarding their adherence in giving medicine to their children. Forty participated in four focus groups. Fifty-two percent of participants reported taking all of their prescribed medication and 47% took it until they felt better. Over 65% of mothers reported giving all prescribed medication to their children. The most frequently cited barriers to adherence included lack of food and clean water, stress, and financial problems. By identifying obstacles to adherence and strategies to overcome them, this study showed that a community-based clinic with committed healthcare workers in Kenya can empower an economically disadvantaged population to be adherent.

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