在埃塞俄比亚一家大型教学医院的肾移植患者中,药物不依从及其相关因素。
Medication non-adherence and its associated factors among kidney transplant patients in a large teaching hospital in Ethiopia.
机构信息
General Public Health, St.Pauìs Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Addis Ababa Burn Emergency and Trauma Hospital, Addis Ababa, Ethiopia.
出版信息
BMC Nephrol. 2024 Jun 1;25(1):187. doi: 10.1186/s12882-024-03620-z.
BACKGROUND
This study examines medication adherence among kidney transplant patients at St. Paul's Hospital Millennium Medical College (SPHMMC) in Addis Ababa, Ethiopia, focusing on the level of adherence and associated factors to immunosuppressant medicines.
METHODS AND MATERIALS
A cross-sectional study was conducted on 270 patients from October 2021 to January 2022 using a structured questionnaire analyzed with SPSS version 26. The prevalence of medication adherence was computed, and a binary logistic regression was fitted to estimate the association. Medication adherence level measurement in post-kidney transplant patients was assessed using the Simplified Medication Adherence Questionnaire (SMAQ) and Basel Adherence Assessment Scale in Immunosuppressants (BAASIS). A 95% confidence interval and p-value < 0.05 were used for statistical significance.
RESULTS
The study found that 71.5% of kidney transplant patients were male, with a median age of 37 and a mean duration of 3.55 years. Medication adherence in post-kidney transplant patients was 81.9%. Post-transplant duration above 5 years and missing follow-up visits more than two times was associated with a 92.6% and 91.2% in medication non-adherence rate respectively. Additionally, forgetfulness was associated with a 90.6%, non-adherence level compared to drug unavailability and financial reasons.
CONCLUSION AND RECOMMENDATION
The study indicates that our patients exhibit higher medication adherence than WHO-measured levels, suggesting the need for healthcare providers to strengthen their intervention, especially for those above 5 years post-kidney transplant. The reason for increased adherence could be explained by the health education program about the medication name, dosing, frequency of ingestion and adverse effects of the drug, and effects of non-adherence.
背景
本研究关注埃塞俄比亚亚的斯亚贝巴圣保罗医院千年医学学院(SPHMMC)的肾移植患者的药物依从性,重点是免疫抑制剂药物的依从水平和相关因素。
方法和材料
2021 年 10 月至 2022 年 1 月期间,采用横断面研究方法,对 270 名患者进行了研究,使用结构问卷进行分析,使用 SPSS 版本 26 进行分析。计算了药物依从性的患病率,并使用二元逻辑回归来估计相关性。使用简化药物依从性问卷(SMAQ)和免疫抑制剂的巴塞尔依从性评估量表(BAASIS)评估肾移植后患者的药物依从性水平。使用 95%置信区间和 p 值<0.05 进行统计显著性检验。
结果
研究发现,71.5%的肾移植患者为男性,中位年龄为 37 岁,平均病程为 3.55 年。肾移植后患者的药物依从性为 81.9%。移植后持续时间超过 5 年和错过两次以上随访与药物不依从率分别为 92.6%和 91.2%相关。此外,健忘与药物不可用和经济原因相比,与 90.6%的非依从水平相关。
结论和建议
研究表明,我们的患者表现出比世界卫生组织测量的水平更高的药物依从性,这表明医疗保健提供者需要加强干预,特别是对于移植后超过 5 年的患者。依从性增加的原因可以用关于药物名称、剂量、摄入频率和药物不良反应以及不依从的影响的健康教育计划来解释。