Medication Adherence Among Patients with Multimorbidity in the United Arab Emirates

Abstract

Background Multimorbidity, defined as having two or more chronic diseases, has a major impact on public health and Sustainable Development Goals (SDG). This study aims to assess the prevalence of medication adherence and associated factors among patients with multimorbidity. Methods A questionnaire-based, cross-sectional survey was conducted by a trained interviewer across patients with multimorbidity attending outpatient clinics in two tertiary referral hospitals in the United Arab Emirates (UAE). Demographic and social variables and the outcome (self-reported adherence to long-term medication) were measured using the General Medication Adherence Scale (GMAS). Multiple logistic regression was used to assess medication adherence and associated factors. Results From a total of 630 participants included in this study, the estimated prevalence of high medication adherence is 78.57% (±1.63478) with a 95% confidence interval (CI) [75.19, 81.61]. The odds of high medication adherence increased with age. The odds of high medication adherence for patients aged 66 years and older than those aged 19–35 years is adjusted odds ratio (AOR) = 3.880, with a 95% CI [1.124, 13.390]. Patients with income more than 50,000 had the odds, AOR = 5.169 with a 95% CI [1.282, 20.843], compared to those earning less than 10,000 Dirhams (AED). Patients aged 36–65 with health insurance coverage had higher medication adherence than groups on the other end. The number of current medications is significantly (p-value = 0.027) associated with high medication adherence with the odds of high medication adherence, AOR = 4.529 with a 95% CI [1.184, 17.326], the highest for those currently taking four medications. Conclusion This study highlights younger population having multimorbidity in the context of an increasing life expectancy and suboptimal therapeutic outcomes. Furthermore, the study highlights multimorbidity is associated with low medication adherence and out-of-pocket payment, and non-availability of insurance is a major hindrance to medication adherence.

Medication adherence and its impact on glycemic control in type 2 diabetes mellitus patients with comorbidity: A multicenter cross-sectional study in Northwest Ethiopia

“…In this study, most of the participants were found to have a low level of medication adherence. This finding is consistent with an earlier study [ 38 ], but it is much higher than the other studies [ 14 , 18 , 36 , 39 – 41 ]. The study findings indicate that a significant proportion of patients with comorbidity fail to achieve the expected adherence level of medications.…”

“…Further, the current study also disclosed that patients with a lower number of medications and medical conditions were found less likely to be low adherent to their medications compared with patients with a higher number of medications and medical conditions. This finding is consistent with previous studies [ 30 , 31 , 36 , 37 ], which higher number of medications and medical conditions resulted in low medication adherence because of medication regimen complexity, medication adverse effects, the inability of patients to afford multiple medications. A higher number of medications may also contribute to the loss of the time of administration of medications.…”

“…The final outcome score used to categorize the medication adherence level as low adherence and high adherence was determined by computing the sum of each item scores. If the overall GMAS score ≤ 26, the patient was categorized under low adherence and patients were categorized under high adherence if the GMAS score was greater than or equal to 27 out of 33 overall maximum points [ 36 ].…”

Medication adherence and its impact on glycemic control in type 2 diabetes mellitus patients with comorbidity: A multicenter cross-sectional study in Northwest Ethiopia

“…In this study, the majority of T2DM patients were found to have a low level of adherence. This nding is consistent with an earlier study (18), but it is much higher than the other studies (14,19,37,(39)(40)(41). The study ndings indicate that a signi cant proportion of patients with comorbidity fails to achieve the expected adherence level of medications.…”

“…The nal outcome score used to categorize the medication adherence level as low adherence and high adherence was determined by computing the sum of each item scores. If the overall GMAS score ≤ 26, the patient was categorized under low adherence and patients were categorized under high adherence if the GMAS score was greater than or equal to 27 out of 33 overall maximum points (37).…”