Shah Medha H, Honnekeri Amalesh S, Samat Divya A, Shah Priyanshi, Nayak Usha V, Kini Shobha G
Pharmacology and Therapeutics, K. J. (Karamshi Jethabhai) Somaiya Medical College, Mumbai, IND.
Internal Medicine, Topiwala National Medical College & B. Y. L. Nair Charitable Hospital, Mumbai, IND.
Cureus. 2023 Oct 4;15(10):e46493. doi: 10.7759/cureus.46493. eCollection 2023 Oct.
Introduction Medication adherence is a critical aspect of managing chronic diseases. Poor medication adherence leads to therapeutic failures and increased health costs, and puts patients at potentially life-threatening risks.The impact is felt drastically by patients suffering from chronic diseases. Patient satisfaction is known to be strongly associated with medication adherence. Psychosocial factors such as depression have been proven to negatively affect medication adherence; however, to our best knowledge, the association of stress with adherence remains largely unexplored. Objectives The aim of this study is to explore or assess the relationship between medication adherence, patient satisfaction, and stress levels. Methods A cross-sectional observational study was conducted within an Indian metropolitan city (Mumbai) among adults diagnosed and treated for at least one chronic disease with a medication regimen spanning over three months. An online questionnaire was designed, incorporating validated scales such as the Adherence to Refills and Medications Scale, Short Assessment of Patient Satisfaction, and Perceived Stress Scale. Results In the study, 23.7% of participants (n=300) showed adherence to their prescribed treatment regimen. Adherence exhibited a positive association with age (p=0.009) and educational attainment (p=0.031). Additionally, a significant gender difference emerged, with males (28%) displaying higher adherence rates compared to females (16.7%) (p=0.036). Furthermore, participants reporting lower stress levels exhibited higher adherence (39.5%), while those experiencing moderate-to-high stress levels displayed reduced adherence rates (17-18.8%) (p<0.05). Patient satisfaction was also linked to adherence, as satisfied individuals demonstrated higher adherence levels (29.1%) in contrast to dissatisfied counterparts (15.7%) (p=0.011). Conclusion Level of medication adherence is much lower in India as compared to other developed nations. Various demographic factors such as age, sex, and education status influence adherence. Physician counselling plays an important role in adherence, and satisfied patients are far more adherent. Furthermore, a significant negative association was found between stress and adherence.
引言
药物依从性是慢性病管理的关键环节。药物依从性差会导致治疗失败、医疗成本增加,并使患者面临潜在的生命危险。慢性病患者深切感受到了这种影响。已知患者满意度与药物依从性密切相关。诸如抑郁等社会心理因素已被证明会对药物依从性产生负面影响;然而,据我们所知,压力与依从性之间的关联在很大程度上仍未得到探索。
目的
本研究的目的是探索或评估药物依从性、患者满意度和压力水平之间的关系。
方法
在印度大都市(孟买)对至少患有一种慢性病且药物治疗方案持续三个月以上的成年人进行了一项横断面观察研究。设计了一份在线问卷,纳入了经过验证的量表,如药物再填充和用药依从性量表、患者满意度简短评估量表和感知压力量表。
结果
在该研究中,23.7%的参与者(n = 300)显示出对规定治疗方案的依从性。依从性与年龄(p = 0.009)和教育程度(p = 0.031)呈正相关。此外,出现了显著的性别差异,男性(28%)的依从率高于女性(16.7%)(p = 0.036)。此外,报告压力水平较低的参与者表现出较高的依从性(39.5%),而经历中度至高度压力水平的参与者依从率较低(17 - 18.8%)(p < 0.05)。患者满意度也与依从性相关,因为满意的个体表现出较高的依从水平(29.1%),而不满意的个体则为(15.7%)(p = 0.011)。
结论
与其他发达国家相比,印度的药物依从性水平要低得多。年龄、性别和教育状况等各种人口统计学因素会影响依从性。医生的咨询在依从性方面起着重要作用,满意的患者依从性更高。此外,还发现压力与依从性之间存在显著的负相关。