Ismail Mohamad, El-Nayal Mayssah, Domiati Souraya
Department of Pharmacy Practice, Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon.
Department of Psychology, Faculty of Human Sciences, Beirut Arab University, Beirut, Lebanon.
Explor Res Clin Soc Pharm. 2024 Aug 25;15:100496. doi: 10.1016/j.rcsop.2024.100496. eCollection 2024 Sep.
Medication non-adherence is a significant barrier to optimal treatment goals. The study explores the association between subjective well-being (SWB) and medication adherence among Lebanese individuals with multiple chronic diseases and identifies additional factors that may influence adherence in this population.
An exploratory, cross-sectional study was conducted for three months at six community pharmacies. Adherence was assessed using the Adherence to Refills and Medication Scale Arabic Lebanese Version (ARMS-A). The SWB was measured using the Arabic Scale of Happiness (ASH), Love of Life Scale (LLS), Arab Hope Scale (AHS), and Satisfaction with Life Scale (SWLS). Spearmen's Rho correlation analyzed the association between ARMS-A and SWB constructs. Binary logistic regression identified predictors of adherence among individuals with chronic diseases and on multiple chronic medications.
Of 400 participants, 106 (26.5 %) with a 95 % CI, 0.22-0.31, were adherent. Lower medication adherence (reflected in higher ARMS-A scores) was associated with lower SWB ( = 0.01). Multivariate analysis showed that lower education (OR = 2.21, 95 % CI, 1.01-4.81), lack of a specific diet (OR = 1.64, 95 % CI, 1.01-2.69), and frequent hospital and/or emergency visits (OR = 3.29, 95 % CI, 1.75-6.17 for 2 visits; OR = 2.71, 95 % CI, 1.43-5.14 for ≥3 visits) significantly increased the odds of non-adherence to chronic treatment. However, higher income (OR = 0.06, 95 % CI, 0.01-0.38), healthcare provider occupation (OR = 0.42, 95 % CI, 0.21-0.48), and having diabetes mellitus (OR = 0.59, 95 % CI, 0.36-0.96) correlated with better adherence.
A significant portion of participants failed to adhere to their prescribed chronic medications, influenced by multicomplex socioeconomic, psychological, and health-related factors. These findings demonstrate the need for culturally-tailored, pharmacist-led interventions to improve medication adherence and overall health outcomes.
药物治疗依从性不佳是实现最佳治疗目标的重大障碍。本研究探讨了黎巴嫩患有多种慢性病的个体主观幸福感（SWB）与药物治疗依从性之间的关联，并确定了可能影响该人群依从性的其他因素。
在六家社区药店进行了为期三个月的探索性横断面研究。使用《阿拉伯语黎巴嫩版药品续方和用药依从性量表》（ARMS-A）评估依从性。使用《阿拉伯语幸福量表》（ASH）、《生活热爱量表》（LLS）、《阿拉伯语希望量表》（AHS）和《生活满意度量表》（SWLS）测量主观幸福感。Spearmen's Rho相关性分析了ARMS-A与主观幸福感结构之间的关联。二元逻辑回归确定了患有慢性病且正在服用多种慢性药物的个体中依从性的预测因素。
在400名参与者中，106名（26.5%），95%置信区间为0.22-0.31，为依从者。较低的药物治疗依从性（以较高的ARMS-A分数反映）与较低的主观幸福感相关（=0.01）。多变量分析表明，较低的教育程度（比值比[OR]=2.21，95%置信区间为1.01-4.81）、缺乏特定饮食（OR=1.64，95%置信区间为1.01-2.69）以及频繁住院和/或急诊就诊（2次就诊时OR=3.29，95%置信区间为1.75-6.17；≥3次就诊时OR=2.71，95%置信区间为1.43-5.14）显著增加了慢性治疗不依从的几率。然而，较高的收入（OR=0.06，95%置信区间为0.01-0.38）、医疗保健提供者职业（OR=0.42，95%置信区间为0.21-0.48）以及患有糖尿病（OR=0.59，95%置信区间为0.36-0.96）与更好的依从性相关。
受多种复杂的社会经济、心理和健康相关因素影响，很大一部分参与者未能坚持服用规定的慢性药物。这些发现表明需要开展针对文化特点的、由药剂师主导的干预措施，以提高药物治疗依从性和整体健康结果。
