埃塞俄比亚西北部南贡德尔地区社区药房慢性病患者药物不依从性的决定因素:一项多中心横断面研究。

Determinants of medication non-adherence among patients with chronic diseases at community pharmacy settings in South Gondar Zone, Northwest Ethiopia: a multicenter cross-sectional study.

机构信息

Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

出版信息

Front Public Health. 2024 Oct 18;12:1409153. doi: 10.3389/fpubh.2024.1409153. eCollection 2024.

Abstract

BACKGROUND

Medication non-adherence is a significant public health concern in managing patients with chronic diseases, and community pharmacists are on the frontline in the management of chronic medications. Chronic diseases require lifelong pharmacotherapy and understanding the determinants of medication adherence has paramount importance to develop strategies that improve medication adherence and treatment outcomes. Thus, this study aimed to assess the magnitude of medication non-adherence and its contributing factors among patients with chronic diseases attending community pharmacies in South Gondar Zone, Northwest Ethiopia.

METHODS

A multicenter cross-sectional study was conducted at community pharmacies in South Gondar Zone from September 01 to October 30, 2023. Medication adherence was assessed using a structured questionnaire using the Adherence in Chronic Diseases Scale (ACDS). Statistical Package for Social Sciences (SPSS) version 25 was used for analysis. Association between the outcome variable and independent variables was performed using binary logistic regression and a -value of <0.05 was considered statistically significant.

RESULTS

Among three hundred and eighty six (386) study participants recruited in this study, more than half of them 222 (57.51%, 95%CI: 52.4% - 62.5%) were low adherent to their medications. Concerning determinants of medication non-adherence; the presence of side effects (AOR =2.1, 95%CI=1.33-3.29), unable to get ever counseling from community pharmacists (AOR=2.3, 95%CI= 1.46-3.58), and poor about their medications (AOR=3.1, 95% CI= 1.96-4.82) were significantly associated with patients' non-adherence to medications.

CONCLUSION

The medication adherence level in this study was suboptimal, with a significant proportion of the patients being non-adherent to their medications. The presence of side effects, unable to get ever counseling, and poor knowledge about their medications were statistically significant factors of poorer medication adherence. Hence, healthcare professionals, especially community pharmacists, have a crucial role in designing the schedule for health education concerning the needs of these patients in community pharmacy settings.

摘要

背景

在管理慢性病患者方面,药物依从性差是一个重大的公共卫生问题,社区药剂师是慢性病管理中处于第一线的人员。慢性病需要终身药物治疗,了解药物依从性的决定因素对于制定提高药物依从性和治疗效果的策略至关重要。因此,本研究旨在评估在埃塞俄比亚西北南贡达尔地区的社区药房就诊的慢性病患者药物不依从的程度及其相关因素。

方法

这是一项于 2023 年 9 月 1 日至 10 月 30 日在南贡达尔地区社区药房进行的多中心横断面研究。使用慢性病用药依从性量表(ACDS)通过结构化问卷评估用药依从性。采用社会科学统计软件包(SPSS)版本 25 进行分析。使用二元逻辑回归分析来评估结局变量与自变量之间的关联,p 值 <0.05 被认为具有统计学意义。

结果

在这项研究中,共招募了 386 名研究参与者,其中超过一半的参与者(222 名,57.51%,95%CI:52.4% - 62.5%)对药物的依从性较低。关于药物不依从的决定因素;存在副作用(AOR=2.1,95%CI=1.33-3.29)、无法从社区药剂师那里获得定期咨询(AOR=2.3,95%CI=1.46-3.58)和对药物了解较差(AOR=3.1,95%CI=1.96-4.82)与患者不依从药物治疗显著相关。

结论

本研究中药物依从性水平不理想,相当一部分患者不依从药物治疗。存在副作用、无法获得定期咨询以及对药物了解较差是药物依从性较差的统计学显著因素。因此,医疗保健专业人员,尤其是社区药剂师,在设计针对这些患者在社区药房环境中的需求的健康教育计划方面具有至关重要的作用。

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