Appropriateness of chronic asthma management and medication adherence in patients visiting ambulatory clinic of Gondar University Hospital: a cross-sectional study

Tesfaye, Zelalem Tilahun; Gebreselase, Nebeyu Tsegu; Horsa, Boressa Adugna

doi:10.1186/s40413-018-0196-1

Cited by 13 publications

(13 citation statements)

References 8 publications

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“…Adherence to medication has already been examined in chronic diseases and cardiac diseases other than congenital heart disease. In these studies, non-adherence was predicted by disease severity, lower education, smoking, and psychiatric comorbidities such as depression and anxiety disorders (17)(18)(19)(20)(21). However, in adults with congenital heart disease, non-adherence to medication has not been evaluated before.…”

Section: Introductionmentioning

confidence: 99%

Factors That Influence Adherence to Medication in Adults With Congenital Heart Disease (ACHD)

et al. 2021

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Objective: Innovative operative and interventional procedures have improved survival in congenital heart disease (CHD), and today more than 90% of these children reach adulthood. Consequently, adherence and psychosocial issues are becoming increasingly important because non-adherence to treatment recommendations worsens morbidity and mortality. This study aimed to identify factors modifying adherence to medication in adult congenital heart disease (ACHD).Methods: This cross-sectional study included 451 outpatients (female 47.9%, average age ± SD: 37.9 ± 12 years) from the ACHD department, who completed a questionnaire assessing medication non-adherence and individual barriers to treatment. Further assessments included psychological well-being (Hospital Anxiety and Depression scale; HADS), childhood traumatization, sociodemographic, and clinical data. Binary logistic regression analysis calculated the impact of these factors on drug adherence.Results: Of the 451 patients 162 participants (35.9%) reported to be non-adherent. In univariate analysis non-adherence to treatment was associated with smoking (P = < 0.001) and internet addiction (P = 0.005). Further factors negatively influencing adherence were the presence of depressive symptoms (P = 0.002), anxiety (P = 0.004), and childhood traumatization (p = 0.002). Factors positively associated with adherence were older age (P = 0.003) and more advanced heart disease as indicated by NYHA class (P = 0.01), elevated NT-proBNP (P = 0.02), device therapy (P = 0.002) and intermittent arrhythmias (P = 0.01). In multivariate analysis especially psychopathological factors such as depression (P = 0.009), anxiety (P = 0.032) and childhood traumatization (P = 0.006) predicted non-adherence.Conclusion: Adherence is a critical issue in the long-term management of ACHD. Identifying modifiable factors that worsen adherence offers the opportunity for targeted interventions. Depressive symptoms, anxiety, and adverse childhood experiences are amenable to psychosocial interventions, as well as cigarette smoking. Our study suggests that a multimodal and interdisciplinary treatment concept for the long-term management of adults with congenital heart disease could be beneficial. Whether it will further improve morbidity and mortality, should be assessed in prospective interventions.

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Section: Introductionmentioning

confidence: 99%

Factors That Influence Adherence to Medication in Adults With Congenital Heart Disease (ACHD)

et al. 2021

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“…Although several studies have been published on the prevalence and associated factors of non-adherence to inhaled medications among adult asthmatic patients in Ethiopia [18][19][20][21][22][23], the general prevalence remains unknown. Therefore, the primary purpose of this systematic review and meta-analysis is to determine the pooled national prevalence of non-adherence to inhaled medications among adult asthmatic patients in Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

Non-adherence to inhaled medications among adult asthmatic patients in Ethiopia: a systematic review and meta-analysis

Aberhe

Hailay

Zereabruk

et al. 2020

asthma res and pract

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Background Medication non-adherence is one of a common problem in asthma management and it is the main factor for uncontrolled asthma. It can result in poor asthma control, which leads to decreased quality of life, increase hospital admission, increased health care utilization, lost productivity, and mortality. To date, there have been no studies and protocols that estimated the pooled national prevalence of non-adherence to inhaled anti-asthmatic medications in Ethiopia. Therefore, the primary purpose of this systematic review and meta-analysis is to determine the pooled national prevalence of non-adherence to inhaled medications among asthmatic patients in Ethiopia. Methods Different database searching engines including PubMed, Scopus, Google Scholar, Africa journal online, World Health Organization afro library, and Cochrane review were systematically searched by using keywords such as “prevalence, non-adherence to inhaled medications, inhaled corticosteroids, and asthmatic patients” and their combinations. Six published observational studies that report the prevalence of non-adherence to inhaled medications were finally selected. The Preferred Reporting Items for Systematic Review and Meta-Analysis guideline was followed. Heterogeneity across the included studies was evaluated by the inconsistency index (I2). The random-effect model was fitted to estimate the pooled prevalence of non-adherence to inhale anti-asthmatic medications. All statistical analysis was done using R version 3.5.3 and R Studio version 1.2.5033 software for windows. Results The pooled national prevalence of non-adherence to inhaled medications among asthmatic patients was 29.95% (95% CI, 19.1, 40.8%). The result of this meta-analysis using the random-effects model revealed that there is high heterogeneity across the included studies. The result of subgroup analysis indicates that one out of three in the Oromia region and one out of five in the Amhara region asthmatic patients was non-adherent to their inhaled anti-asthmatic medications. Conclusion the prevalence of non-adherence to inhaled anti-asthmatic medications was high. Thus, our finding suggests that one out of four asthmatic patients were non-adherent to inhaled medications. The ministry of health, health policymakers, clinicians, and other health care providers should pay attention to strengthening the adherence levels to inhaled anti-asthmatic medications, and country-based interventions should be developed to reduce the burden of non-adherence to inhaled anti-asthmatic medications.

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“…In Ethiopia, adherence to anti-asthmatic medication was reported to be 56.7% in Gondar town [ 12 ], and 49.4% in Addis Ababa City [ 13 ]. However, according to a recent systematic review and meta-analysis results, nearly 30% of asthmatic patients in Ethiopia have poor adherence to anti-asthmatic medications [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, only a few studies elucidate the extent of adherence to anti-asthmatic medications among asthma patients. Furthermore, these studies only focused on a patient’s level of adherence to specific types of treatment regimens; inhalation medications [ 13 , 15 ], inadequate sample size and conducted at a single health facility [ 10 , 12 , 17 ] yielding unrepresentative data. Therefore, the current study was conducted at six different hospitals with adequate sample size, and includes all types of anti-asthmatic medications to assess the level of adherence to anti-asthmatic medications and associated factors among asthmatic patients attending governmental hospitals in Eastern Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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.

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Appropriateness of chronic asthma management and medication adherence in patients visiting ambulatory clinic of Gondar University Hospital: a cross-sectional study

Cited by 13 publications

References 8 publications

Factors That Influence Adherence to Medication in Adults With Congenital Heart Disease (ACHD)

Factors That Influence Adherence to Medication in Adults With Congenital Heart Disease (ACHD)

Non-adherence to inhaled medications among adult asthmatic patients in Ethiopia: a systematic review and meta-analysis

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

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