Doctors’ views and strategies to improve patients’ adherence to medication

Yfantopoulos, John; Protopapa, Marianna; Chantzaras, Athanasios; Yfantopoulos, Platonas

doi:10.1007/s42000-021-00294-2

Cited by 10 publications

(9 citation statements)

References 78 publications

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“…Patient and socio-demographic factors (economic status, age, literacy status, cultural and personal perceptions) and healthcare and facility factors (convenience of pharmacy, medication regimen complexity, and clinical characteristics of the patients) could affect adherence to medication in asthma patients [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Medication regimen complexity and its impact on medication adherence and asthma control among patients with asthma in Ethiopian referral hospitals

Belachew

Netere

Sendekie

2022

asthma res and pract

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Background Various studies have found that medication adherence is generally low among patients with asthma, and that the complexity of the regimen may be a potential factor. However, there is no information on the complexity of the regimen and its relationship to adherence and asthma outcomes in Ethiopian asthma patients. Therefore, this study assessed how complex medication regimens affected medication adherence and asthma control in patients with asthma. Method From February 1 to May 30, 2022, a multicenter cross-sectional study was conducted in three public referral hospitals in northwestern Ethiopia. The Medication Complexity Index (MRCI), a 65-item validated instrument, was used to represent the complexity of medication regimens The Medication Adherence Rating Scale for Asthma (MARS-A) was used to assess medication adherence, and the ACT was used to measure the level of asthma control. The association between predictor and outcome variables was determined using multivariable logistic regression analysis. P-values of < 0.05 were declared as a significant association. Result Patients with asthma (n = 396) who met the inclusion criteria were included in the final analysis. About 21.2% and 24.5% of the participants had high asthma-specific MRCI and patient-level MRCI, respectively. The majority (84.4%) of the participants did not adhere to their medication, and 71% of the participants were classified as having uncontrolled asthma. According to the result of the multivariable analysis, moving from a high asthma-specific MRCI to a moderate asthma MRCI enhances the likelihood of medication adherence by 2.51 times (AOR = 2.51, 95%CI: (1.27, 7.71). Likewise, patients who have low asthma MRCI were four times more likely to adhere to the medication compared with high asthma MRCI (AOR = 3.80, 95%CI: (2.0, 11.1). Similarly, patients having low patient-level MRCI were eight times more likely their asthma level had been controlled (AOR = 7.84, 95%CI: 1.46 to 21.3) and patients who had moderate patient-level MRCI were three times (AOR = 2.83, 95%CI: 1.05 to 8.25) more controlled asthma compared with patients who had high patient level MRCI. Conclusion The majority of asthma patients had low and moderate complexity of MRCI. Patients with low and moderate regimen complexity demonstrated high adherence and had well-controlled asthma. Therefore, future researchers should consider MRCI as one factor for adherence and asthma control levels.

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Section: Introductionmentioning

confidence: 99%

Medication regimen complexity and its impact on medication adherence and asthma control among patients with asthma in Ethiopian referral hospitals

Belachew

Netere

Sendekie

2022

asthma res and pract

View full text Add to dashboard Cite

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“…Few data are available in literature on the time course of MA, possibly as a consequence of the different methods and periods used in its measurement 31. MA has been shown to drop in the first weeks following discharge after a cardiac event,32 though doctors in charge of patients with cardiovascular diseases do not seem to be aware of this behaviour 33. It also decreases at the beginning of therapy for chronic obstructive pulmonary disease,11 and in the first period of topical treatment for psoriasis 34.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of adherence to pharmacological treatments by undocumented migrants with chronic diseases: a 10-year retrospective cohort study

Fiorini,

Pellegrini,

Franchi

et al. 2024

BMJ Open

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ObjectivesTo investigate the time course of medication adherence and some of the factors involved in this process in undocumented migrants with chronic diseases.DesignRetrospective cohort study.SettingA big non-governmental organisation in Milano, Italy, giving medical assistance to undocumented migrants.Participants1918 patients, 998 females and 920 males, with at least one chronic condition (diabetes, cardiovascular diseases (CVDs), mental health disorders) seen over a period of 10 years (2011–2020). Their mean age was 49.2±13 years.ResultsAdherence to medications decreased over 1 year in all patients. This was more evident during the first 2 months of treatment. Patients on only one medication were less adherent than those on more than one medication; at 6 months the percentage of patients with high adherence was 33% vs 57% (p<0.0001) for diabetes, 15% vs 46% (p<0.0001) for mental disorders and 35% vs 59% (p<0.0001) for CVDs. Patients with mental disorders had the lowest adherence: 25% at 6 months and 3% at 1 year. Mental disorders, when present as comorbidities, greatly reduced the probability of being highly adherent: risk ratio (RR) 0.72 (95% CI 0.57 to 0.91; p=0.006) at 3 months, RR 0.77, (95% CI 0.59 to 1.01; p=0.06) at 6 months, RR 0.35 (95% CI 0.13 to 0.94; p=0.04) at 1 year. This was especially evident for patients with CVDs, whose percentage of high adherents decreased to 30% (p=0.0008) at 6 months and to 3% (p=0.01) at 1 year. We also noted that highly adherent patients usually were those most frequently seen by a doctor.ConclusionsInterventions to increase medication adherence of undocumented migrants with chronic diseases are necessary, particularly in the first 2 months after beginning treatment. These should be aimed at people-centred care and include more outpatient consultations. Educational interventions should especially be taken into consideration for patients on monotherapy.

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“…Another study reported that lack of professional support for patients aggravated patient anxiety and doubtfulness, reduced their coping ability, and hence, reduced their treatment acceptance 53. On the other hand, strong professional patient support by healthcare providers enhances patient satisfaction and adherence to treatments 54…”

Section: Discussionmentioning

confidence: 99%

Barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease in Iran: a descriptive qualitative study

Sami,

Salehi,

Hashemi

et al. 2023

BMJ Open

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ObjectivesChronic obstructive pulmonary disease is a chronic disease with numerous complications. Therefore, its effective management depends on home-based pulmonary rehabilitation. The effectiveness of home-based pulmonary rehabilitation programmes in turn depends on patient adherence to them. The aim of this study was to explore the barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease.DesignQualitative descriptive design.SettingThe lung care wards of Al-Zahra and Khorshid teaching hospitals and the comprehensive lung care clinic of Khorshid hospital, Isfahan, Iran.ParticipantsParticipants patients with chronic obstructive pulmonary disease (n=20), their family caregivers (n=15) and healthcare providers (n=14) recruited via purposive sampling.ResultsThe five main categories of the barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease were patient-related barriers, caregivers’ caregiving burden, limited support for patients, healthcare providers’ limited professional competence and ineffective home-based pulmonary rehabilitation planning.ConclusionDifferent and complex factors related to patients, families and healthcare providers can affect adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease. Healthcare authorities can use the findings of this study to develop strategies to support patients with chronic obstructive pulmonary disease and their family caregivers and thereby reduce the physical and mental complications of Chronic obstructive pulmonary disease.

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Doctors’ views and strategies to improve patients’ adherence to medication

Cited by 10 publications

References 78 publications

Medication regimen complexity and its impact on medication adherence and asthma control among patients with asthma in Ethiopian referral hospitals

Medication regimen complexity and its impact on medication adherence and asthma control among patients with asthma in Ethiopian referral hospitals

Evaluation of adherence to pharmacological treatments by undocumented migrants with chronic diseases: a 10-year retrospective cohort study

Barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease in Iran: a descriptive qualitative study

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