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埃塞俄比亚亚的斯亚贝巴抗癫痫药物的依从性和药物的自我报告可及性和可负担性。

Adherence to anti-seizure medications and self-reported availability and affordability of the medications in Addis Ababa, Ethiopia.

机构信息

Reproductive Health and Population Department, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.

Epidemiology and Biostatistics Department, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.

出版信息

PLoS One. 2024 Oct 10;19(10):e0299964. doi: 10.1371/journal.pone.0299964. eCollection 2024.

Abstract

BACKGROUND

Anti-seizure medications (ASMs) are the primary therapeutic mode to control seizures in patients with epilepsy. Adherence to the medications is critical to achieving the goals of epilepsy therapy. However, the cost of the medications and the interrupted availability of ASMs contribute to non-adherence to epilepsy treatment. Therefore, this study aimed to assess ASM adherence and its association with self-reported medication availability and affordability.

OBJECTIVE

To assess whether self-reported availability and affordability of Anti-seizure medications affect medication adherence among Epileptic Patients at Eka Kotebe General Hospital, Addis Ababa, Ethiopia, from January 13, 2023 to March 23, 2023.

METHODS

A hospital-based analytical cross-sectional study was conducted among 357 epileptic patients using the Consecutive sampling method in Eka Kotebe General Hospital, Addis Ababa, Ethiopia. ASM adherence was measured using a self-report 3items questionnaire focusing on medication use patterns of patients from their last visit to the current visit. Statistical packages for Social Sciences 26.0 version statistical software cleaned, coded and analyzed the collected data. Binary logistic regression was fitted, and P-values less than 0.05 were considered to have statistical significance.

RESULT

The prevalence of ASM adherence was 55.2% with 95% CI (50.1%; 60.2%). About two-thirds (61.3%) of patients in this study had limited access to the ASMs or could not afford the medications. Self-reported availability of ASMs (AOR = 2.01, 95% CI = 1.01, 3.98) was significantly associated with ASM adherence. Self-reported affordability of ASMs was associated with ASM adherence in the Bivariate logistic regression analysis; however, when adjusted for other covariates in the multivariable logistic regression, no significant association was observed (p = 0.674).

CONCLUSION AND RECOMMENDATION

Only about half of the epileptic patients adhered to ASMs at Eka Kotebe General Hospital. Self-reported availability of ASMs was an essential factor. Improving access to ASMs is critical to improving adherence and management of epilepsy.

摘要

背景

抗癫痫药物(ASM)是控制癫痫患者癫痫发作的主要治疗方式。坚持用药对于实现癫痫治疗目标至关重要。然而,药物费用和供应中断导致患者无法坚持治疗。因此,本研究旨在评估 ASM 依从性及其与自我报告的药物可得性和可负担性的关系。

目的

评估自我报告的抗癫痫药物的可得性和可负担性是否会影响埃塞俄比亚亚的斯亚贝巴 Eka Kotebe 综合医院的癫痫患者的药物依从性,研究时间为 2023 年 1 月 13 日至 3 月 23 日。

方法

采用连续抽样法,在埃塞俄比亚亚的斯亚贝巴 Eka Kotebe 综合医院进行了一项基于医院的分析性横断面研究,共纳入 357 名癫痫患者。采用自我报告的 3 项问卷评估 ASM 依从性,重点关注患者从上一次就诊到本次就诊期间的用药模式。使用社会科学统计软件包 26.0 版本对收集的数据进行清理、编码和分析。拟合二项逻辑回归,P 值小于 0.05 被认为具有统计学意义。

结果

ASM 依从性的患病率为 55.2%,95%CI(50.1%;60.2%)。在这项研究中,约三分之二(61.3%)的患者获得 ASM 或无法负担这些药物。自我报告的 ASM 可得性(AOR = 2.01,95%CI = 1.01,3.98)与 ASM 依从性显著相关。在二元逻辑回归分析中,自我报告的 ASM 可负担性与 ASM 依从性相关;然而,在多变量逻辑回归分析中,当调整其他协变量时,没有观察到显著关联(p = 0.674)。

结论和建议

在 Eka Kotebe 综合医院,只有约一半的癫痫患者坚持服用 ASM。自我报告的 ASM 可得性是一个重要因素。改善 ASM 的可及性对于提高癫痫的依从性和管理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4b2/11469612/35f1eb96623f/pone.0299964.g001.jpg

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