scholarly journals A cross-sectional study clarifying profiles of patients with diabetes who discontinued pharmacotherapy: reasons and consequences.

Author(s):  
Yoshiko Tominaga ◽  
Donald Morisky ◽  
Mayumi Mochizuki

Abstract Background: Although diabetes is one of the fastest increasing diseases in prevalence worldwide and demands significant medical resources, more than half of all patients with diabetes do not achieve the expected target level of blood glucose. As a potential cause of poor glycemic control, insufficient adherence to medication has long been discussed and variably studied. However, dropout from treatment as another plausible cause has not been fully examined. The aim of this study was to clarify profiles of patients with diabetes who discontinued pharmacotherapy (Discont group) by extracting reasons of their decisions and by comparing results with those who continued (Cont group).Methods: A cross-sectional, internet-based survey was conducted among Japanese with diabetes registered in a database. A self-administered questionnaire consisting of the 8-item version of the Morisky Medication Adherence Scale (MMAS-8), glycosylated haemoglobin (HbA1c) level, and demographic and disease characteristics was completed by all participants. Reasons for medication discontinuation and resumption were also received from participants in the Discont group. To examine the risk of uncontrolled HbA1c, logistic regression analysis was conducted in each group.Results: In the Discont group (148 cases), older age at resumption of pharmacotherapy and current smoking habit increased the probability of uncontrolled HbA1c, whereas in the Cont group (146 cases), a familial history of diabetes and better medication adherence in MMAS-8 scores decreased the probability of uncontrolled HbA1c. A relationship between medication adherence and HbA1c level was seen in the Cont but not in the Discont group. About 70% of those in the Discont group made their decision to terminate diabetes treatment without consulting physicians.Conclusions: Those who discontinued pharmacotherapy were less adherent to medication than those who did not discontinue. Risk factors for glycemic control also differed between those who discontinued and those who did not. More than one-third of participants with diabetes who discontinued pharmacotherapy had inappropriate perceptions of their disease, which medical professionals should be aware of for better inventions.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoshiko Tominaga ◽  
Donald E. Morisky ◽  
Mayumi Mochizuki

Abstract Background Although diabetes is one of the fastest increasing diseases in prevalence worldwide and demands significant medical resources, more than half of all patients with diabetes do not achieve the expected target level of blood glucose. As a potential cause of poor glycemic control, insufficient adherence to medication has long been discussed and variably studied. However, dropout from treatment as another plausible cause has not been fully examined. The aim of this study was to clarify profiles of patients with diabetes who discontinued pharmacotherapy (Discont group) by extracting reasons of their decisions and by comparing with those who continued (Cont group) in terms of the related factors to glycemic control. Methods A cross-sectional, internet-based survey was conducted among Japanese with diabetes registered in a database. A self-administered questionnaire consisting of the 8-item version of the Morisky Medication Adherence Scale (MMAS-8), glycosylated haemoglobin (HbA1c) level, and demographic and disease characteristics was completed by all participants. Reasons for medication discontinuation and resumption were also received retrospectively from participants in the Discont group. To examine the risk of uncontrolled HbA1c, logistic regression analysis was conducted in each group. Results In the Discont group (148 cases), older age at resumption of pharmacotherapy and current smoking habit increased the probability of uncontrolled HbA1c, whereas in the Cont group (146 cases), a familial history of diabetes and better medication adherence in MMAS-8 scores decreased the probability of uncontrolled HbA1c. A relationship between medication adherence and HbA1c level was seen in the Cont but not in the Discont group. About 70 % of those in the Discont group made their decision to terminate diabetes treatment without consulting physicians and half of them perceived their situations inappropriately. Conclusions Those who discontinued pharmacotherapy were less adherent to medication than those who did not discontinue. Risk factors for glycemic control also differed between those who discontinued and those who did not. More than one-third of participants with diabetes who discontinued pharmacotherapy had inappropriate perceptions of their disease, which medical professionals should be aware of for better interventions.


2020 ◽  
Vol 11 ◽  
pp. 215013272097191
Author(s):  
Maher R. Khdour ◽  
Heba B. Awadallah ◽  
Mustafa A. Alnadi ◽  
Doaa H. Al-Hamed

Introduction: To examine the mean differences between patient beliefs about medicine with reference to adherence and glycemic control. Methods: This study utilized a cross-sectional questionnaire-based approach. Adherence to medication was measured with the Morisky Green Levine Medication Adherence Scale (MGLS); glycemic control as the last HbA1c test value; and beliefs about medicine with the Beliefs about Medicines Questionnaire (BMQ). Results: According to MGLS scale, 220 (57.9%) of the diabetic patients were classified as high adherent to their medications and 160 (42.1%) were classified as low adherent. Patients had strong believes in their medication, the mean necessity score was significantly outweighed the mean concerns score (17.7 vs 14.4; P < .001). Low adherent patients had significantly more concerns about long term effect of medications (14.4 vs 13.8; P < .008). No significant mean differences were found between glycemic controlled and uncontrolled group regarding necessity or concern domains. Conclusion: Assessing beliefs about medicine is crucial for recognizing patients at risk of low adherence, which offers a way to help patients with diabetes to achieve a better glycemic control.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Asmamaw Getnet ◽  
Solomon Meseret Woldeyohannes ◽  
Lulu Bekana ◽  
Tesfa Mekonen ◽  
Wubalem Fekadu ◽  
...  

Introduction. Antiepileptic drugs are effective in the treatment of epilepsy to the extent that about 70% of people with epilepsy can be seizure-free, but poor adherence to medication is major problem to sustained remission and functional restoration. The aim of this study was to assess the prevalence and associated factors of antiepileptic drug nonadherence. Methods. Cross-sectional study was conducted on 450 individuals who were selected by systematic random sampling method. Antiepileptic drug nonadherence was measured by Morisky Medication Adherence Scale (MMAS) and logistic regression was used to look for significant associations. Result. The prevalence of AEDs nonadherence was 37.8%. Being on treatment for 6 years and above [AOR = 3.47, 95% CI: 1.88, 6.40], payment for AEDs [AOR = 2.76, 95% CI: 1.73, 4.42], lack of health information [AOR = 2.20, 95% CI: 1.41,3.43], poor social support [AOR = 1.88, 95%, CI: 1.01, 3.50], perceived stigma [AOR = 2.27, 95% CI: 1.45, 3.56], and experience side effect [AOR = 1.70, 95% CI: 1.06, 2.72] were significantly associated with antiepileptic drug nonadherence. Conclusion. More than one-third of people with epilepsy were not compliant with their AEDs. Giving health information about epilepsy and its management and consequent reduction in stigma will help for medication adherence.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
R. Bou Serhal ◽  
P. Salameh ◽  
N. Wakim ◽  
C. Issa ◽  
B. Kassem ◽  
...  

Background. A new Lebanese scale measuring medication adherence considered socioeconomic and cultural factors not taken into account by the eight-item Morisky Medication Adherence Scale (MMAS-8). Objectives were to validate the new adherence scale and its prediction of hypertension control, compared to MMAS-8, and to assess adherence rates and factors. Methodology. A cross-sectional study, including 405 patients, was performed in outpatient cardiology clinics of three hospitals in Beirut. Blood pressure was measured, a questionnaire filled, and sodium intake estimated by a urine test. Logistic regression defined predictors of hypertension control and adherence. Results. 54.9% had controlled hypertension. 82.4% were adherent by the new scale, which showed good internal consistency, adequate questions (KMO coefficient = 0.743), and four factors. It predicted hypertension control (OR = 1.217; p value = 0.003), unlike MMAS-8, but the scores were correlated (ICC average measure = 0.651; p value < 0.001). Stress and smoking predicted nonadherence. Conclusion. This study elaborated a validated, practical, and useful tool measuring adherence to medications in Lebanese hypertensive patients.


2020 ◽  
pp. 105477382098138
Author(s):  
Fatma Ilknur Cinar ◽  
Şule Mumcu ◽  
Betülay Kiliç ◽  
Ülkü Polat ◽  
Bilge Bal Özkaptan

Low medication adherence is one of the leading causes that affect the achievement of target levels for hypertension. Identifying modifiable factors associated with low adherence is crucial. This study aims to assess medication adherence and the role of beliefs about medicines on medication adherence among hypertensive patients.This cross-sectional study was conducted with 200 hypertension patients.Data were collected using the Morisky-Green-Levine Medication Adherence Scale, and the Beliefs about Medicines Questionnaire [BMQ-Turkish Translation (BMQ-T)]. It was found that the BMQ-T subscales of Specific Concern (β = 0.358, p = .027) and General Overuse (β = 0.552, p = .011) had an independent predictor effect on medication adherence scores. In this study, the patients who thought that drugs were overused and had concerns about this were seen to be less adherent with the medication. With regard to patients who use antihypertensive drugs but have uncontrolled blood pressure, their beliefs about drugs should not be ignored when evaluating adherence with drug therapy.


2019 ◽  
Vol 25 (3-4) ◽  
pp. 100-105 ◽  
Author(s):  
Rawnaq Adil Aladhab ◽  
Majid Hameed Alabbood

<b><i>Background:</i></b> Poor adherence to treatment regimens is a complex problem, especially for those with chronic illnesses. Noncompliance is believed to be the most common reason for treatment failure in diabetic patients, leading to the absence of metabolic control and accelerating disease-related complications. Data on the adherence of people with diabetes in Iraq are lacking. <b><i>Objectives:</i></b> The purpose of this study was to measure the rate of adherence among Iraqi patients with diabetes. <b><i>Methods:</i></b> This was a cross-sectional study conducted in the Specialized Endocrine and Diabetes Center in Basra, southern Iraq, during the period from June to August 2018. Data were collected by completing an interviewing questionnaire consisting of 13 questions. <b><i>Results:</i></b> A total of 231 patients were included in the study (54.5% were female). Mean age was 51.85 ± 13.55 years. 65.4% of the participants were taking their medications at the right times. The most common reason for not taking their medication (48.8%) was difficulty in remembering the dosage times. 40.7% of the participants were sedentary. Only one-third of the patients followed their doctors’ instructions regarding diet. <b><i>Conclusions:</i></b> The rate of adherence to medication regimens and lifestyle advice was unsatisfactory in this study group. The awareness of diabetic patients and their caring physicians about the importance of adherence to therapy, exercise, and diet should be emphasized.


2021 ◽  
Vol 49 (4) ◽  
pp. 215-222
Author(s):  
Rizqinda Lailatul Lestari ◽  
Tina Handayani Nasution ◽  
Ahmad Hasyim Wibisono ◽  
Miftakhul Jannah ◽  
Ulfi Nur Widiyanti ◽  
...  

Lupus is a chronic autoimmune disease that can become a bio-psycho-socio-economic-culture-spiritual burden for individuals because its complex treatment and management. Self-acceptance and adherence to medication are the keys in lupus management. Purpose of this study was to determine the relationship between self-acceptance level of lupus patients and their medication adherence level. The study was designed using a correlational study with a cross sectional approach. About 92 lupus patient respondents at Kupu Parahita Indonesia Foundation who went to the Saiful Anwar Hospital Malang were selected using purposive sampling according to inclusion and exclusion criteria. Respondents were asked to fill out a modified Acceptance of Illness questionnaire to measure patient self-acceptance level and the Morisky Medication Adherence Scale 8 (MMAS-8) to assess drug adherence level. From the 92 respondents, it was found that 37% had a high level of self-acceptance, 52.2% were moderate, and 10.8% were low. Adherence medication level in 92 respondents showed 51.1% high, 38.1% moderate, and 10.8% low. Spearman test results showed a significant relationship between self-acceptance level and medication adherence level (p=0.001, r=0.355). This value indicates the strength of the weak relationship and the direction of the positive correlation between self-acceptance and medication adherence. Conclusion, the higher of self-acceptance level of lupus patients, the higher medication adherence level.


2021 ◽  
Vol 18 (5) ◽  
pp. 1123-1132
Author(s):  
Muhammad Amer ◽  
Nisar-Ur-Rahman ◽  
Saeed-Ur-Rashid Nazir ◽  
Atif Raza ◽  
Humayun Riaz ◽  
...  

Purpose: To determine knowledge regarding hypertension, adherence to medication and HealthRelated Quality of Life (HRQoL), and their associations in hypertensive patients in Pakistan. Methods: A cross-sectional study was conducted among 384 hypertensive patients attending a tertiary health care public sector hospital in Islamabad, Pakistan. Data were collected using knowledge questionnaire regarding hypertension, Morisky Medication Adherence Scale, and EuroQol (EQ-5D) scale. Results: The mean systolic and diastolic blood pressures of the 384 patients were 140.39 ± 15.485 and 88.74 ± 10.683 mmHg, respectively. The coefficient of correlation between knowledge regarding hypertension and adherence was 0.638 (p < 0.001), showing a positive association. The correlation coefficient between knowledge and HRQoL was 0.709 (p < 0.001), suggesting a good association. The correlation coefficient between adherence to medication and HRQoL was 0.545 (p < 0.001), which indicated a positive correlation. Conclusion: These results indicate that there are statistically significant associations between hypertension knowledge and HRQoL, hypertension knowledge and medication adherence, and between adherence and HRQoL in the hypertensive patients studied.


Author(s):  
Niraimathi G ◽  
Sivaraman S

Diabetes mellitus is a growing cause of disease burden worldwide. In order to maintain the glycemic control, multifaceted management and pharmacotherapy are playing vital role. Data related to medication adherence among the affected patients are not much recorded in developing countries like India. In this study, the level of adherence and factor influencing non-adherence to diabetic medication among patients with type II diabetes was assessed. This is a hospital based cross sectional study among adult patients receiving diabetic care. The medication adherence was assessed using the Medication compliance questionnaire. Factors associated with non-adherence to medication were determined using basic and adjusted multivariable logistic regression models. A total of 101 patients with type II diabetes were recruited for this study. Most of the patients told that they practiced both aerobic exercises and diet along with their medication for diabetic management. Nearly 90% of the patients adherent to diet and maximum of 73% patients took oral hypoglycemic agents (OHA) alone followed both combination of OHA and insulin. Out of 101 patients, 67 had co-morbid psychiatric illness including mood disorders, neurotic stress and somatoform disorder. Adherence to treatment with diabetic is moderate in this study with more than half of participants being non-adherent. Urgent interventions are required to tackle this problem in combined efforts to stem this looming diabetes epidemic. Keywords: Diabetes mellitus, life style modifications, treatment adherence


Author(s):  
James P. Sheppard ◽  
Ali Albasri ◽  
Pankaj Gupta ◽  
Prashanth Patel ◽  
Kamlesh Khunti ◽  
...  

AbstractAnalysis of urine samples using liquid chromatography-tandem mass spectrometry (LC-MS/MS) has previously revealed high rates of non-adherence to antihypertensive medication. It is unclear whether these rates represent those in the general population. This study aimed to investigate whether it is feasible to collect urine samples in a primary care setting and analyse them using LC-MS/MS to detect non-adherence to antihypertensive medication. This study used a prospective, observational cohort design. Consecutive patients were recruited opportunistically from five general practices in UK primary care. They were aged ≥65 years with hypertension and had at least one antihypertensive prescription. Participants were asked to provide a urine sample for analysis of medication adherence. Samples were sent to a laboratory via post and analysed using LC-MS/MS. Predictors of adherence to medication were explored with multivariable logistic regression. Of 349 consecutive patients approached for the study, 214 (61.3%) gave informed consent and 191 (54.7%) provided a valid urine sample for analysis. Participants were aged 76.2 ± 6.6 years and taking a median of 2 antihypertensive medications (IQR 1–3). A total of 27/191 participants (14.2%) reported not taking all of their medications on the day of urine sample collection. However, LC-MS/MS analysis of samples revealed only 4/27 (9/191 in total; 4.7%) were non-adherent to some of their medications. Patients prescribed more antihypertensive medications were less likely to be adherent (OR 0.24, 95%CI 0.09–0.65). Biochemical testing for antihypertensive medication adherence is feasible in routine primary care, although non-adherence to medication is generally low, and therefore widespread testing is not indicated.


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