Effect of 2 Models of Care and Factors Predicting Patients' Adherence to Doctor's Appointment Attendance in Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria.

Background: Provision of antiretroviral therapy in resource limited settings has put pressure on the available infrastructure.

Objectives: The study examined patients' adherence to Doctor's appointment attendance after an intervention changing the model of care and factors that predicted adherence.

Methods: Observational study was carried out over four years. The model of care was changed in the last year and the effect assessed. SPSS version 15.0 was used for analysis. Predictors of adherence were determined using logistic regression model.

Results: Over half 148 (59.7%) of the patients were females, with a mean age of 40.4±8.8 years and baseline CD4 cells of 143.5±92.7cells/microliters. "Adherence" rates were 51.3% in 2007, 35.9% in 2008 and 14.9% in 2009 giving patients' average adherence to Doctor's appointment attendance of 34.03%. Intervention changing the model of care in 2010 recorded an adherence rate of 93.1%.

Conclusions: The change in model of care greatly improved patients' "adherence". Patients' knowledge of management, adherence, and smoking and drinking habits were identified as statistically significant predictors of adherence.