Assessment of Medication Adherence Barriers in COPD Patients in A Secondary Care Teaching Hospital
Abstract
Background: COPD is characterised by persistent airway obstruction in which better clinical outcome can be attained by appropriate management of disease. Adherence to COPD medication is poorly understood due to chronic nature of the disease. It is crucial to identify the barriers of non-adherence to build up and execute policies and interventions to upgrade medication adherence. Objective: To identify the predisposing barriers of medication adherence and to find the association between medication adherence and variables. Methods: A descriptive analytical study was conducted and data was collected from COPD outpatients. The Morisky Medication Adherence Scale was used to measure adherence and self-assessed questionnaire was employed to identify the predictors of poor adherence. Chi square test was carried out to find the relationship between medication adherence and variables such as age, gender, literacy, socioeconomic class, polypharmacy, delivery device and climate. Results: A total of 403 patients were involved in the study where 68% reported lower adherence. The most common adherence barriers found were forgetfulness (88%), intentional stoppage of medicines when symptoms improve (83%) and negligence towards medication (82%).A significant association was found between gender, literacy, socioeconomic class, polypharmacy, delivery device and climate. Conclusion: Adherence to medication regimen in COPD patients is poor, even though it is a preventable and a treatable disease. Well-structured education, training, counseling is required to overcome medication adherence particularly among illiterate and low socioeconomic class patients. The combined interventions should be used such as video clips demonstrations of inhaler technique should be given.
Keywords: COPD, Morisky medication adherence scale, Chi square test.
Keywords:
COPD, Morisky medication adherence scale, Chi square testDOI
https://doi.org/10.22270/jddt.v10i2-s.4013References
World Health Organisation. Adherence to long-term therapies: evidence for action
Restrepo RD, Alvarez MT, Wittnebel LD, Sorenson H, Wettstein R, Vines DL et al. Medication adherence issues in patients treated for COPD. Int J COPD. 2008 Sep 3; (3):371-384
Kardas P, Lewek P, Matyjasczyk M. Determinants of patient adherence: a review of systematic reviews. Front Pharmacol. 2013 Jul 25;4:91
Toyama T, Kawayama T, Kinoshita T, Imamura Y, Yoshida M ,Takahashi M et al. Differences in Adherence Barriers to Inhaled Medicines between Japanese Patients with Chronic Obstructive Pulmonary Disease and Asthma Evaluated using the “Adherence Starts with Knowledge 20” (ASK-20) Questionnaire. Internal Medicine 2019:0488-17
Agh T, Inotai A, Mezsaros A. Factors associated with medication adherence in patients with chronic obstructive pulmonary disease. Respiration. 2011; 82(4):328–34.
World Health Organisation (WHO). Chronic Obstructive Pulmonary Disease. Factsheet 315. http://www.who.int/mediacentre/factsheets/fs315/en/ (accessed 22September2015).
Roberts NJ, Ghiassi R, Patridge MR. Health literacy in COPD. International journal of chronic obstructive pulmonary disease. 2008 Dec; 3(4):499
Dias A, Pereira C, Monteiro MJ, Santos C. Patient’s beliefs about medicines and adherence to medication in ischemic heart disease. Atencion primaria 2014 Nov 1; 46:101-6
Gelaw BK, Mohammed A, Tegegne GT, Defersha AD , Fromsa M, Tadesse E et al. Non-adherence and contributing factors among ambulatory patients with antidiabetic medications in Adama Referral Hospital. Journal of diabetes research 2014; 2014.
Ross S, Walker A, Macleod MJ. Patient compliance in hypertension: role of illness perceptions and treatment beliefs. Journal of human hypertension. 2004 Sep; 18(9):607
Davis E, Marra C, Gamble JM, Farrell J, Lockyer J, FitzGerald JM et al.Effectiveness of a pharmacist-driven intervention in COPD (EPIC): study protocol for a randomized controlled trail. Trials. 2016 Dec; 17(1):502
Kokturk N, Polatil M, Oguzulgen IK, Saleemi S, Al Ghobain M, Khan J et al. Adherence to COPD treatement in Turkey and Saudi Arabia:results of the aDCare study. International journal of chronic obstructive pulmonary disease. 2018; 13;1377
Kale MS, Federman AD, Krauskopf K, Wolf M, O’Conor R, Martynenko M et al. The association of health literacy with illness and medication beliefs among patients with chronic obstructive pulmonary disease. PLoS One. 2015 Apr 27; 10(4):e0123937
Roberts NJ, Ghiassi R, Patridge MR. Health literacy in COPD. International journal of chronic obstructive pulmonary disease.2008 Dec;3(4):499
Bourbeau J, Barlett SJ. Patient adherence in COPD.Thorax. 2008 Sep 1; 63(9):831-8
Laforest L, Denis F, Van Gansea E, Ritleng C, Saussier C, Passante N et al. Correlates of adherence to respiratory drugs in COPD patients. Primary Care Respiratory Journal. 2010 Jan 21; 19(2):148
Gadkari AS, McHorney CA. Unintentional non-adherence to chronic prescription medications: how unintentional is it really? BMC health sevices research. 2012 Dec; 12(1):98.
Fugate AR, Kadam AM, Ganachari MS. Prospective Study of Medication Adherence Pattern in Chronic Obstructive Pulmonary Disease and Asthma Patient’s in Tertiary Care teaching Hospital. Indian Journal of Pharmacy Practice. 2015 Apr; 8(2):79
Galal IH, Mohammad YM, Nada AA, Mohran YE. Medication adherence and treatment satisfaction in some Egyptian patients with chronic obstructive pulmonary disease and bronchial asthma. Egyptian Journal of Bronchology. 2018 Jan 1; 12(1):33
Apps LD, Harrison SL, Williams JE, Hudson N, Steiner M, Morgan MD et al. How do informal self-care strategies evolve among patients with chronic obstructive pulmonary disease managed in primary care? A qualitative study. International journal of chronic obstructive pulmonary disease. 2014; 9:257
Published


How to Cite
Issue
Section
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).