Adherence to treatment and related factors among patients with chronic conditions in primary care: a cross-sectional study

Abstract Background Adherence to treatment, a public health issue, is of particular importance in chronic disease therapies. Primary care practices offer ideal venues for the effective care and management of these conditions. The aim of this study is to assess adherence to treatment and related-factors among patients with chronic conditions in primary care settings. Methods A cross-sectional study was conducted among 299 adult patients with ≥1 chronic condition(s) and prescribed medication in primary healthcare centers of Spain. The Morisky-Green-Levine questionnaire was used to assess medication adherence via face-to-face interviews. Crude and adjusted multivariable logistic regression models were used to analyze factors associated with adherence using the Multidimensional Model proposed by the World Health Organization — social and economic, healthcare team and system-related, condition-related, therapy-related, and patient-related factors. Results The proportion of adherent patients to treatment was 55.5%. Older age (adjusted odds ratio 1.31 per 10-year increment, 95% CI 1.01–1.70), lower number of pharmacies used for medication refills (0.65, 95% CI 0.47–0.90), having received complete treatment information (3.89, 95% CI 2.09–7.21), having adequate knowledge about medication regimen (4.17, 95% CI 2.23–7.80), and self-perception of a good quality of life (2.17, 95% CI 1.18–4.02) were independent factors associated with adherence. Conclusions Adherence to treatment for chronic conditions remained low in primary care. Optimal achievement of appropriate levels of adherence through tailored multifaceted interventions will require attention to the multidimensional factors found in this study, particularly those related to patients’ education and their information needs.

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Physician and patient-related factors associated with inappropriate prescribing to older patients within primary care: a cross-sectional study in Brazil

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2020.0411.r1.18112020 ◽

2021 ◽

Vol 139 (2) ◽

pp. 107-116

Author(s):

Welma Wildes Amorim ◽

Luiz Carlos Passos ◽

Romana Santos Gama ◽

Renato Morais Souza ◽

Lucas Teixeira Graia ◽

...

Keyword(s):

Primary Care ◽

Older Patients ◽

Inappropriate Prescribing ◽

Cross Sectional Study ◽

Sectional Study ◽

Related Factors ◽

Cross Sectional ◽

Factors Associated

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Factors associated with patients’ and GPs’ assessment of the burden of treatment in multimorbid patients: a cross-sectional study in primary care

BMC Family Practice ◽

10.1186/s12875-019-0974-z ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 3

Author(s):

Lilli Herzig ◽

Andreas Zeller ◽

Jérôme Pasquier ◽

Sven Streit ◽

Stefan Neuner-Jehle ◽

...

Keyword(s):

Primary Care ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Burden Of Treatment ◽

Multimorbid Patients

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Age differences in demographic, social and health-related factors associated with loneliness across the adult life span (19–65 years): a cross-sectional study in the Netherlands

BMC Public Health ◽

10.1186/s12889-020-09208-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Thanée Franssen ◽

Mandy Stijnen ◽

Femke Hamers ◽

Francine Schneider

Keyword(s):

The Netherlands ◽

Age Differences ◽

Adult Life ◽

Cross Sectional Study ◽

Sectional Study ◽

Related Factors ◽

Adult Life Span ◽

Cross Sectional ◽

Factors Associated ◽

Health Related

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Primary care and population factors associated with NHS Health Check coverage: a national cross-sectional study

Journal of Public Health ◽

10.1093/pubmed/fdt069 ◽

2013 ◽

Vol 35 (3) ◽

pp. 431-439 ◽

Cited By ~ 29

Author(s):

M. Artac ◽

A. R. H. Dalton ◽

H. Babu ◽

S. Bates ◽

C. Millett ◽

...

Keyword(s):

Primary Care ◽

Cross Sectional Study ◽

Health Check ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Nhs Health Check

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Factors associated with inappropriate attitude towards antibiotic usage among outpatients of a large public primary care center in Malaysia: A cross sectional study.

10.21203/rs.3.rs-17290/v1 ◽

2020 ◽

Author(s):

Zati Sabrina Ahmad Zubaidi ◽

Khasnur Abdul Malek ◽

Zaliha Ismail

Keyword(s):

Primary Care ◽

Cross Sectional Study ◽

Antibiotic Usage ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Care Specialist ◽

Low Education ◽

Knowledge And Attitude ◽

The Relationship

Abstract Background: Antibiotic resistance is one of the biggest global threat in modern medicine. The situation is even more consequential in lower-and middle-income countries (LMIC) as financial limitations and political instability may become barriers to an impactful health policy. Therefore, The World Health organization has urge all nations to increase public awareness on antibiotic through effective educational interventions. In order for interventions to be successful, it is important to acknowledge that each country is unique in its problems as the demographic in LMIC are diverse. This study aims to identify the community’s attitude appropriateness towards antibiotic usage and their knowledge gaps, the relationship between antibiotic knowledge and their attitude as well as factors associated with inappropriate attitude towards antibiotic among outpatients attending an established primary care specialist center in Malaysia.Methodology : This cross-sectional study was conducted among 256 respondents attending a public primary care specialist clinic center. Those who fulfilled the inclusion and exclusion criteria from June to August 2017 were given a self-administered, validated and translated questionnaire. Pearson correlation was used to deduce the relationship between knowledge and attitude. Chi square test, independent t-test and multiple logistic regression were used to determine factors associated with inappropriate attitude towards antibiotic.Results: It was found that the respondents’ mean attitude and knowledge score were 29.5 ± 4.19 and 5.94 ± 2.4 respectively. The highest inappropriate attitude response was expecting antibiotic from the doctor for common colds and the most frequent incorrect knowledge response was on the domain of role of antibiotics. There is a weak positive relationship between antibiotic knowledge and attitude (r=0.315, n=256, p=0.0001). Respondents with low education level and poor antibiotic knowledge were at least 2.5 times more likely to have inappropriate attitude when handling antibiotics.Conclusion: Our study demonstrated the common inappropriate attitude towards antibiotic and areas of knowledge gap among the population. Antibiotic education should be incorporated in non-pharmacological measures of viral illnesses that is targeted among those with low education and poor antibiotic knowledge. The weak relationship between antibiotic knowledge and attitude suggest that health campaign should focus on behavioral change rather than a theoretical approach.

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Factors associated with shared decision making among primary care physicians: Findings from a multicentre cross-sectional study

Health Expectations ◽

10.1111/hex.12603 ◽

2017 ◽

Vol 21 (1) ◽

pp. 212-221 ◽

Cited By ~ 14

Author(s):

Matthew Menear ◽

Mirjam Marjolein Garvelink ◽

Rhéda Adekpedjou ◽

Maria Margarita Becerra Perez ◽

Hubert Robitaille ◽

...

Keyword(s):

Primary Care ◽

Decision Making ◽

Shared Decision Making ◽

Primary Care Physicians ◽

Cross Sectional Study ◽

Shared Decision ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated

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Multimorbidity and patterns of chronic conditions in a primary care population in Switzerland: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2016-013664 ◽

2017 ◽

Vol 7 (6) ◽

pp. e013664 ◽

Cited By ~ 17

Author(s):

Anouk Déruaz-Luyet ◽

A Alexandra N'Goran ◽

Nicolas Senn ◽

Patrick Bodenmann ◽

Jérôme Pasquier ◽

...

Keyword(s):

Primary Care ◽

Chronic Conditions ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Primary Care Population

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Physician related barriers towards insulin therapy at primary care centres in Trinidad: a cross-sectional study

BMC Family Practice ◽

10.1186/s12875-020-01271-1 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Shastri Motilal

Keyword(s):

Primary Care ◽

Insulin Therapy ◽

Primary Care Physicians ◽

Online Survey ◽

Cross Sectional Study ◽

Sectional Study ◽

Related Factors ◽

Cross Sectional ◽

Convenience Sample ◽

The Public

Abstract Background Physician related factors with respect to insulin therapy can contribute to diabetes mellitus (DM) mismanagement. Patient related factors have been previously explored in a Trinidad survey. The main objective of this study was to explore primary care physicians’ (PCPs) related barriers towards insulin therapy. Methods A cross-sectional study on a convenience sample of PCPs in the public primary care system was done using an online survey. Results Of the 170 PCPs contacted, 75 (44%) responded. There were 47 females (62.7%) and 28 males (37.3%) with a mean age of 35.9 yrs. Nearly 40% of physicians admitted that the education given to patients was inadequate to allow initiation of insulin therapy. Half the respondents admitted to insufficient consultation times and inadequate appointment frequency to allow for intensification of insulin therapy. Forty percent of PCPs admitted that HbA1c results were unavailable to guide their management decisions. Only 6.7% of physicians said they had access to rapid acting insulin, while 5.3% said they had access to insulin pens. Conclusion PCPs in Trinidad treating diabetes at the public primary care clinics face several barriers in administering proper insulin therapy. Addressing these factors can improve glycemic control in this population.

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Prevalence and coprevalence of chronic comorbid conditions in patients with type 2 diabetes in Catalonia: a population-based cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-031281 ◽

2019 ◽

Vol 9 (10) ◽

pp. e031281 ◽

Cited By ~ 5

Author(s):

Manel Mata-Cases ◽

Josep Franch-Nadal ◽

Jordi Real ◽

Marta Cedenilla ◽

Didac Mauricio

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Primary Care ◽

Chronic Conditions ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Sectional Study ◽

Cross Sectional

ObjectivesTo evaluate the prevalence and coprevalence of several chronic conditions in patients with type 2 diabetes in a Mediterranean region.DesignA cross-sectional study.SettingTwo hundred and eighty-six primary care teams of the Catalonian Health Institute (Catalonia, Spain).ParticipantsWe included patients aged ≥18 years with a diagnosis of type 2 diabetes by 31 December, 2016, who were registered in the Information System for the Development of Research in primary care (SIDIAP) database. We excluded patients with a diagnosis of type 1 diabetes, gestational diabetes mellitus and any other type of diabetes.Primary and secondary outcome measuresWe collected data on diabetes-related comorbidities (ie, chronic complications, associated cardiovascular risk factors and treatment complications). Diagnoses were based on the International Classification of Diseases, 10thRevision codes recorded in the database or, for some entities, on the cut-off points for a particular test result or a specific treatment indicated for that entity. The presence and stage of chronic kidney disease (CKD) were based on the glomerular filtration rate, the CKD Epidemiology Collaboration creatinine equation and the urine albumin-to-creatinine ratio.ResultsA total of 373 185 patients were analysed. 82% of patients exhibited ≥2 comorbidities and 31% exhibited ≥4 comorbidities. The most frequent comorbidities were hypertension (72%), hyperlipidaemia (60%), obesity (45%), CKD (33%), chronic renal failure (CRF)(28%) and cardiovascular disease (23%). The most frequently coprevalent pairs of chronic conditions were the combination of hypertension with hyperlipidaemia (45%), obesity (35%), CKD (28%), CRF (25%) or cardiovascular disease (19%), as well as the combination of hyperlipidaemia with obesity (28%), CKD (21%), CRF (18%) or cardiovascular disease (15%); other common pairs of comorbidities were obesity/CKD, obesity/CRF, hypertension/retinopathy, hypertension/albuminuria, hypertension/urinary tract infection, CVD/CRF and CVD/CKD, which were each present in more than 10% of patients.ConclusionPatients with type 2 diabetes have a high frequency of coprevalence of metabolic risk factors, cardiovascular disease and CKD and thus require an integrated management approach.

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