Dagnew Samuel Berihun, Moges Tilaye Arega, Tarekegn Getachew Yitayew, Wondm Samuel Agegnew, Assefa Abraham Nigussie, Bekahegn Mulugeta Ashagie, Sisay Zewdu Woretaw
Clinical Pharmacy, Debre Tabor University, Debre Tabor, Ethiopia
Clinical Pharmacy, Debre Tabor University, Debre Tabor, Ethiopia.
BMJ Open. 2025 Jun 22;15(6):e095666. doi: 10.1136/bmjopen-2024-095666.
Due to numerous comorbidities, complicated medical regimens and age-related difficulties, older adults frequently confront substantial treatment burdens and poor medication adherence, which could result in poor health outcomes. This study assessed the treatment burden and medication adherence among older adults in comprehensive specialised hospitals in the Amhara Region in Ethiopia.
A multicentre hospital-based cross-sectional study was conducted from 30 March to 30 July 2024.
The study was conducted at four comprehensive specialised hospitals in Northwest Ethiopia.
Patients were ≥65 years old, diagnosed with two chronic illnesses and were receiving medical attention for the relevant issue.
This study employed the Multimorbidity Treatment Burden Questionnaire to assess treatment burden and the General Medication Adherence Scale to assess medication adherence. Data analysis was conducted using STATA version 17. Linear and binary logistic regressions were used to analyse the dependent variables of treatment burden and medication adherence to the determining factors, respectively.
422 patients took part in this study. Regarding treatment burden, 75% report a high burden. Of the patients, 32.20% adhered well, whereas 67.80% did not. The medication regimen complexity index (MRCI; β=0.029, 95% CI 0.001 to 0.058; p=0.047), age (β=0.027, 95% CI 0.009 to 0.044; p=0.004) and number of medications (β=0.168, 95% CI 0.045 to 0.291; p=0.007) were associated with higher treatment burden. Variables associated with medication non-adherence included rural residence (adjusted OR 2.249, 95% CI, 1.356 to 3.732; p=0.002), care provided by relatives (1.744, 1.055 to 2.883; p=0.030), moderate Charlson comorbidity index (CCI; 2.241, 1.220 to 4.117; p=0.009), severe CCI (6.953, 3.526 to 13.715; p=0.000), polypharmacy (1.615, 1.055 to 3.230; p=0.044) and treatment burden (1.501, 1.023 to 3.090; p=0.015).
Of the older adult patients enrolled in this study, three-quarters had a high treatment burden, and more than two-thirds had poor adherence. A high treatment burden was associated with age, medication use and MRCI, whereas non-adherence was associated with self-management, residency, CCI, medication use, MRCI and treatment burden.
由于多种合并症、复杂的医疗方案以及与年龄相关的困难，老年人经常面临巨大的治疗负担和较差的药物依从性，这可能导致不良的健康结果。本研究评估了埃塞俄比亚阿姆哈拉地区综合专科医院中老年人的治疗负担和药物依从性。
于2024年3月30日至7月30日进行了一项基于多中心医院的横断面研究。
该研究在埃塞俄比亚西北部的四家综合专科医院进行。
患者年龄≥65岁，被诊断患有两种慢性疾病，并因相关问题正在接受治疗。
本研究采用多重疾病治疗负担问卷评估治疗负担，采用一般药物依从性量表评估药物依从性。使用STATA 17版进行数据分析。分别采用线性回归和二元逻辑回归分析治疗负担和药物依从性的因变量与决定因素之间的关系。
422名患者参与了本研究。关于治疗负担，75%的患者报告负担较重。在这些患者中，32.20%依从性良好，而67.80%依从性不佳。药物治疗方案复杂性指数（MRCI；β=0.029，95%可信区间0.001至0.058；p=0.047）、年龄（β=0.027，95%可信区间0.009至0.044；p=0.004）和药物数量（β=0.168，95%可信区间0.045至0.291；p=0.007）与较高的治疗负担相关。与药物不依从相关的变量包括农村居住（调整后比值比2.249，95%可信区间1.356至3.732；p=0.002）、亲属提供护理（1.744，1.055至2.883；p=0.030）、中度查尔森合并症指数（CCI；2.241，1.220至4.117；p=0.009）、重度CCI（6.953，3.526至13.715；p=0.000）、多种药物治疗（I.615，1.055至3.230；p=0.044）和治疗负担（1.501，1.023至3.090；p=0.015）。
在本研究纳入的老年患者中，四分之三有较高的治疗负担，超过三分之二依从性较差。较高的治疗负担与年龄、药物使用和MRCI相关，而不依从与自我管理、居住情况、CCI、药物使用、MRCI和治疗负担相关。
