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埃塞俄比亚西北部贡德尔大学综合专科医院心力衰竭患者的药物治疗不依从性及相关因素

Medication Nonadherence and Associated Factors among Heart Failure Patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

作者信息

Seid Mohammed Assen, Toleha Husien Nurahmed, Sema Faisel Dula

机构信息

Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Ethiopia.

Department of Social and Administrative Pharmacy, Wollo University, Ethiopia.

出版信息

Int J Chronic Dis. 2023 Jan 14;2023:1824987. doi: 10.1155/2023/1824987. eCollection 2023.

Abstract

BACKGROUND

Medication nonadherence, being one of the best predictors of hospitalization, increases the mortality rate and hospital readmission and reduces the quality of life of heart failure (HF) patients. Therefore, this study is aimed at assessing medication nonadherence and associated factors among HF patients at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

METHODS

A cross-sectional study was conducted among 245 adult patients with HF from June to August 2017. The data were collected by using the medication Adherence Report Scale (MARS-5) and then entered and analyzed using SPSS® (IBM Corporation) version 24. Summary statistics were presented using frequency, proportion, and mean. Binary logistic regression analysis was done for identifying factors associated with medication nonadherence with a 95% confidence level and value of less than 0.05.

RESULTS

Among 245 patients with HF, about a quarter (23.7%) of them were medication nonadherent. More than one-third (37%) of HF patients had a history of at least one HF medication discontinuation. Refilling problems (48%) and getting better from the illness (27%) were the most commonly reported reasons for nonadherence. Presence of comorbidity (AOR = 2.761; 95%CI = 1.364, 5.589), taking three or more types of medication (AOR = 2.805; 95%CI = 1.404, 5.60), and being unmarried (AOR = 2.638, 95%CI = 1.279, 5.443) was significantly associated with medication nonadherence.

CONCLUSION

The self-reported medication nonadherence among HF patients was considerably high. Refilling problems and getting better from the illness were the most commonly reported reasons for nonadherence. The presence of comorbid illness, taking three or more types of medication, and being unmarried was significantly associated factors of medication nonadherence. Awareness creation among patients on the importance of medication adherence and targeted efforts to assess and mitigate reasons for medication nonadherence may be helpful.

摘要

背景

药物治疗不依从是住院的最佳预测因素之一,它会增加死亡率和再入院率,并降低心力衰竭(HF)患者的生活质量。因此,本研究旨在评估埃塞俄比亚西北部贡德尔大学综合专科医院HF患者的药物治疗不依从情况及相关因素。

方法

2017年6月至8月,对245例成年HF患者进行了一项横断面研究。使用药物依从性报告量表(MARS-5)收集数据,然后使用SPSS®(IBM公司)24版进行录入和分析。使用频率、比例和均值呈现描述性统计数据。进行二元逻辑回归分析,以确定与药物治疗不依从相关的因素,置信水平为95%,P值小于0.05。

结果

在245例HF患者中,约四分之一(23.7%)的患者存在药物治疗不依从情况。超过三分之一(37%)的HF患者有至少停用一种HF药物的病史。最常报告的不依从原因是重新配药问题(48%)和病情好转(27%)。合并症的存在(比值比[AOR]=2.761;95%置信区间[CI]=1.364,5.589)、服用三种或更多类型的药物(AOR=2.805;95%CI=1.404,5.60)以及未婚(AOR=2.638,95%CI=1.279,5.443)与药物治疗不依从显著相关。

结论

HF患者自我报告的药物治疗不依从情况相当高。重新配药问题和病情好转是最常报告的不依从原因。合并症的存在、服用三种或更多类型的药物以及未婚是药物治疗不依从的显著相关因素。提高患者对药物依从性重要性的认识,并针对性地努力评估和减轻药物治疗不依从的原因可能会有所帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c974/9867578/44e433a3517f/IJCD2023-1824987.001.jpg

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