Adherence to anti-asthma medications among adult asthmatic patients in Eastern Ethiopia: A multi-center cross-sectional study

Abstract

Introduction Adherence to anti-asthmatic medications plays a vital role in enhancing an asthma patient’s quality of life and prognosis. However, in Ethiopia, the level of adherence and contributing factors were rarely studied. Therefore, this study was conducted to determine the level of adherence to anti-asthma medications and associated factors among adult asthmatic patients in Eastern Ethiopia. Method Institutional based cross-sectional study was conducted at six governmental hospitals found in Eastern Ethiopia. A total of 320 asthma patients aged 18 years and above and using asthma medicines for at least 12 months were involved. An interviewer based structured questionnaires were used to collect the data. Bivariable and multivariable logistic regression analyses were carried out using IBM SPSS version 22 (SPSS, Chicago, IL). The Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to determine the strength of association between independent variables and outcome variable. Variables with a p-value of ≤ 0.05 were considered statistically significant. Result Of the 320 asthma patients that participated in the study, 109(34.1%:28.8–39.1%) of them had good adherence to anti-asthmatic medications. Being a housewife (AOR = 4.265, 95%CI: 1.333, 13.653), having good knowledge about asthma (AOR = 2.921, 95%CI (1.472, 5.795), positive attitude towards asthma (AOR = 3.129, 95%CI: 1.555, 6.293), and use of oral corticosteroid drugs (AOR = 1.967, 95%CI: 1.008, 3.841) were factors positively associated with good adherence to anti-asthmatic medications. Participants on treatment for 2–3 years (AOR = .295, 95%CI: 0.099, 0.873), and those on medication for ≥ 4 years (AOR = 0.229, 95%CI: 0.079, 0.664) were 70.5% and 77.1% times less likely to adhere to anti-asthmatic medications respectively. Conclusion The current study signified a low level of adherence to anti-asthmatic medications. Participant’s characteristics and medication related factors were significantly associated with good adherence to anti-asthmatic medications. Health education and advice during follow-up for asthma patients is crucial for better adherence.

Prevalence of medication adherence among adult asthmatic patients in four African countries: A systematic review and meta-analysis

“…Of the included studies, 7 focused on adherence to specifically inhaled medications among adult asthmatic patients 3 , 16 , 17 , 29 , 31 , 35 , 38 but the remaining 9 studies focused on any type of anti-asthmatic medications. 11 , 12 , 28 , 30 , 32 , 33 , 34 , 36 , 37 The lowest prevalence of adherence to anti-asthmatic medications (13.9%) was reported in Ethiopia 16 and the highest (62.1%) was reported by another study conducted in Ethiopia. 17 The pooled random effects prevalence of adherence to medications among adult patients with asthma in Africa was 39% (95% CI: 32, 47; p < 0.001).…”

“…About 14 studies included in this review were cross-sectional 3 , 11 , 16 , 17 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 and the remaining 2 were case-control and prospective cohort. 12 , 38 Of the included studies 9 were from Ethiopia, 11 , 12 , 16 , 17 , 28 , 29 , 30 , 34 3 from Egypt, 3 , 33 , 38 3 from Nigeria, 31 , 32 , 36 and the remaining 1 was from Tanzania. 35 The sample size of the included studies ranged from 110 3 to 474 33 with a total sample size of 4019 adults living with asthma.…”

“… 11 , 12 , 16 , 17 , 28 , 29 , 30 , 32 , 33 , 34 , 35 , 38 All the included studies measured adherence to medications by using self-report medication adherence measurement tools. Of the included studies, 6 used the Morisky Medication Adherence Scale, 3 , 12 , 30 , 33 , 37 , 38 3 studies used Medication Adherence Rating Scale-Asthma, 11 , 16 , 34 3 used Test of the Adherence to Inhalers, 17 , 29 , 35 and 1 study used Adherence Starts with Knowledge. 28 But the remaining 3 studies 31 , 32 , 36 did not use a validated tool to determine the prevalence of medication adherence ( Table 1 ).…”

Adherence to treatment recommendations of patients with chronic non-communicable respiratory diseases – a narrative review

“…Asthma patients initiating triple therapy with FF/UMEC/VI had significantly better adherence and persistence compared to MITT initiators. In contrast, a study conducted in six government hospitals in eastern Ethiopia involving 320 asthmatic patients showed low adherence to anti-asthma medications [42]. Patients on treatment for 2-3 years and those on medication for ≥ 4 years were 70.5% and 77.1% times less likely to adhere to anti-asthmatic medications, respectively.…”