Why adherence to medical directions ensures patient safety

Two-times-three; two pills in the morning, two in the afternoon and two before you go to sleep. You should also keep hands off red meat, sugar, cigarette and beer. After that, check on your doctor every first day of the week.

Two-times-three; two pills in the morning, two in the afternoon and two before you go to sleep. You should also keep hands off red meat, sugar, cigarette and beer. After that, check on your doctor every first day of the week. 

That is a typical medical prescription but it’s as well anyone’s decision to ignore or respect the recommendations.

Whereas some individuals on medication may ditch their pills after gaining some strength, other patients hardly find any hardships abiding or staying in touch with health professions when need for checkup arises. 

Disease-causing agents usually fail to etch their burden in people who adhere to their medication instruction. Those who give up easily on medication, though, have a different date with fate to tell.

But what drives patients to risk their safety yet all run to hospital for a cure?

“Patient non-adherence to medical treatment may be attributed to the cost of drugs, quantity of the dosage and other lifestyle factors,” say Alex Nshimiyimana, a dispenser pharmacist at Abacus Pharmacy in Nyarugenge District.

Cases differ from one patient to another, which means that only those who deeply understand why it is important to take drugs in time and as recommended fall on a safer side.

Nshimiyimana, for example, explains that elderly patients are usually cautious of the dosage and whenever confusion arise, they seek advice.

Although some of them stay with caretakers responsible for keeping details of their drug regimen, any considerate patient should try to keep record of their medical progress. 

The World Health Organisation defines patient safety as a healthcare discipline that emphasises the reporting, analysis, and prevention of medical errors that often lead to adverse healthcare events.

Tomorrow is World Patient Safety Day, a day WHO launched in 2005 to increase the awareness of unsafe healthcare. The purpose of Patient Safety Day is to revolutionise high level support and commitment to tackle patient safety issues in all parts of the world.

WHO warns that patient safety is a serious global public health issue. Estimates show that in developed countries as many as one in 10 patients is harmed while receiving hospital care.

Of every 100 hospitalised patients at any given time, seven in developed and 10 in developing countries will acquire health care-associated infections. Hundreds of millions of patients are affected by this worldwide each year.

In recent years, countries have increasingly recognised the importance of improving patient safety. However, a lot still remain to be done to meet the standards.

Failure to complete dosage

Non-adherence is worse when it comes to long courses of drugs.

“Patients may choose not to take their medicine because the taste of the drugs,” says Doreen Iradukunda, a nursing assistant at Isango Clinique Medicale in Kigali.

“Of course, bitter medicine is less pleasurable and I would rather opt for other options if any,” says Maureen Manzi, a resident of Kanombe.

This is something that even Gaston Makombe, a physician at Rwanda Military Hospital, Kanombe, cannot deny.

“Some patients fail to follow a doctor’s prescription simply because they hate bitter drugs. With such medication, few individuals comply,” Makombe says.


Makombe warns of the dangers of failure to adhere to prescription.

“By the time you decide to take medication, the body may already be too weak to react positively to the medicine. This is when the side effects become severe and cause more discomfort, which in turn makes more people reject the medication.’’

“Injections and pills are not fun, but failure to take your medication as required is likely to bring about drug resistance,” he adds.

Solange Umubyeyi, a public health at Dama Clinic, Remera says that, “Once you fail to adhere to the drugs, you stand a chance of even spending more money because the sickness may re occur and as well be forced to begin the dose afresh.”

Because when you misuse a certain drug, you out to run out of options for cheaper drugs, Umubyeyi therefore advises that: “Patients should endeavor to treat infections at an early stage and use the medicines as required to avoid the increase in multidrug resistance.” Medics also warn of the issues where a patient is warned off certain things but will continue to do them even during medication.

High on the list is smoking. Many smokers, even when admitted to hospital, continue to burn with the urge and will do all they can to sneak a fag for a puff.

The problem is that when a patient who has been told off drugs like cigarettes and alcohol insists on indulging in them, the efficacy of the drug could be affected or some interactions within the body could cause adverse effects to the body.