Medication Non-adherence in Patients with Osteoporosis: Implications for Clinical Pharmacists and Osteoporosis Care Providers

Jarab, Anan S.; Mukattash, Tareq L.; Hilan, Hayat

doi:10.2174/1574884715666200116104754

Cited by 6 publications

(10 citation statements)

References 24 publications

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“…44 In a recent Jordanian study among patients with osteoporosis, it has been observed that the medication non-adherence was affected by the increased number of prescribed medications. 46 Therefore, a simplified regimen possibly with STR or fixed-dose combination might provide a reasonable clinical solution to improve adherence. Moreover, a metaanalysis by Igaly et al has indicated that once-weekly dosing of treatment for osteoporosis was associated with better adherence levels and higher odds of being adherent as compared to the once-daily dosing.…”

Section: Combination Of More Than One Simplification Strategymentioning

confidence: 99%

<p>Impact of Medication Regimen Simplification on Medication Adherence and Clinical Outcomes in Patients with Long-Term Medical Conditions</p>

Elnaem¹,

Irwan²,

Abubakar³

et al. 2020

PPA

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Background This study aims to identify interventions used to reduce medication regimen complexity and to assess their impact on medication adherence and clinical outcomes. Methods A literature search was conducted using pre-defined search terms in three scientific databases, including ScienceDirect, ProQuest and MEDLINE. Original research articles published in English between 2009 and 2020 that assessed the impact of medication regimen simplification on medication adherence in patients with long-term medical conditions were eligible for inclusion. Review articles, meta-analysis studies and conference proceedings were excluded. Data charting was done in an iterative process using a study-specific extraction form. Results Of the 684 studies identified through initial searches, 17 studies were included in the review. Nine studies involved simplification of medication regimen related to HIV, while three studies focused on patients with diabetes with or without coronary artery disease. The remaining five studies included medications used among elderly patients or medications related to hypertension, psychiatric disorders, glaucoma and kidney diseases. Three medication regimen simplification strategies were identified; fixed-dose combination (n = 7), once-daily dosing (n = 4) and the combination of both fixed-dose and once-daily dosing (n = 6). Overall, most of the regimen simplification strategies (14 out of 17) were found to be useful in improving medication adherence. There was no assessment of clinical outcomes in four out of 17 studies. Furthermore, more than half of the studies that assessed clinical outcomes did not show any additional impact on clinical outcomes. Conclusion The findings suggest that there was an equal utilization of the three main approaches of regimen simplifications; fixed-dose combination, once-daily dosing and a combination of both. Overall, most of the regimen simplification strategies were found to be effective in improving medication adherence. However, the associated improvement in medication adherence did not extend to improvement in the clinical outcomes.

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Section: Combination Of More Than One Simplification Strategymentioning

confidence: 99%

<p>Impact of Medication Regimen Simplification on Medication Adherence and Clinical Outcomes in Patients with Long-Term Medical Conditions</p>

Elnaem¹,

Irwan²,

Abubakar³

et al. 2020

PPA

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“…25,26 Similar findings were also reported in Jordanian patients with osteoporosis who reported 72.3% medication non-adherence rate. 27 Better medication adherence rate to anti-diabetics (72.4%), antihypertensive (50.7%) and lipid-lowering medications (44.3%) were reported in an elderly population in Spain. 28 A meta-analysis study reported that statins represent the most effective treatment to control lipid levels and to decrease the risk TA B L E 1 Characteristics of the study participants (n = 228) of stroke and coronary artery disease in all age groups.…”

Section: Discussionmentioning

confidence: 90%

“…Increased treatment complexity by the administration of several doses or prescribing multiple medications have been associated with low adherence levels 32 . A study conducted at an outpatient osteoporosis clinic at the Royal Medical Services Hospital in Jordan reported that patients were less likely to adhere to the prescribed medications with each unit increase in the number of prescribed medications 27 . Other studies revealed that the increased number of prescribed medications and the frequency of administration were associated with medication non‐adherence in patients with type 2 diabetes 33‐35 …”

Section: Discussionmentioning

confidence: 99%

Lipid control and its associated factors among patients with dyslipidaemia in Jordan

Jarab

Alefishat

Al‐Qerem

et al. 2021

Int. J. Clin. Pract.

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Background: Lipid control represents a cornerstone in the management of atherosclerotic cardiovascular disease (ASCVD). Nevertheless, little research has explored the factors associated with poor lipid control in patients with dyslipidaemia. Objective:The study aim was to investigate the variables associated with poor lipid control among patients with dyslipidaemia in Jordan.Method: In addition to socio-demographics, disease and medication-related variables, lipid profile including total cholesterol, LDL-C, HDL-C and triglyceride and other biomedical variables were collected for patients diagnosed with dyslipidaemia using hospital medical charts at three major outpatient clinics in Jordan. The validated 4-item medication adherence scale and the beliefs about medications questionnaire were used to evaluate medication adherence and medication beliefs among the study participants. The participants were classified to have controlled and uncontrolled dyslipidaemia using recent AHA guidelines. A stepwise forward conditional binary regression was conducted to explore the variables significantly and independently associated with dyslipidaemia control. A P-value of < .05 was considered statistically significant.Results: A total of 228 patients participated in the study. Most of the study participants (61%) were classified to have uncontrolled lipid profile and 60.1% of them were found to have ASCVD. Regression analysis revealed that increased necessity for How to cite this article:

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“…Available data revealed that adherence to medications among patients suffering from chronic diseases averages 50% in the developed countries [3]. In the MENA region, including Jordan, these rates have been showed to be even lower [4][5][6][7][8][9][10]. In a study conducted among Jordanians receiving long-term treatment for different conditions, most of the participants showed to have poor adherence to their treatments [4].…”

Section: Introductionmentioning

confidence: 99%

“…In a study conducted among Jordanians receiving long-term treatment for different conditions, most of the participants showed to have poor adherence to their treatments [4]. When looking to patients taking chronic medications for specific chronic diseases such as COPD, asthma or osteoporosis, the results were comparable, also demonstrating low rates of adherence [5][6][7]. In the MENA region, few studies reporting results from different middle eastern countries confirmed the presence of nonadherence as a problem among patients with chronic diseases [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Translation and validation of the Arabic version of the Morisky, Green and Levine (MGL) adherence scale

et al. 2022

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The Morisky Green Levine (MGL) adherence scale is a 4-item tool used for the detection of medication nonadherence among patients with chronic health conditions. Despite being widely used in Arabic-speaking research contexts, it has never been validated in Arabic language. The aim of this study was to translate and validate the MGL tool into Arabic. A standard forward-backward process was used to translate the questionnaire. Cronbach’s alpha coefficient was measured to assess internal consistency of the scale. The test-retest reliability measured the consistency of participants’ responses over time. Construct validity was evaluated by Explanatory factor analysis (EFA); Kaiser-Meyer-Olkin value and Bartlett’s test of sphericity were determined. Convergent validity was assessed using a preexisting medications Arabic Adherence Assessment Tool (AAAT). The model fit was evaluated using confirmatory factor analysis (CFA). Associations between the MGL scale scores and the patient demographic/clinical characteristics were tested by linear regressions. A total of 201 participants were included into the study. The MGL scale categorization revealed that 20.9%, 59.2% and 19.9% of the participants had high, moderate and low levels of adherence respectively. Adequate internal consistency (alpha = 0.593) was observed. A significant strong ICC and Pearson’s correlations were generated between responses at time 1 and time 2. EFA results elucidated the suitability of the data for factor analysis. Pearson’s coefficient (r) revealed a significant strong correlation between MGL scale and AAAT. CFA results confirmed a good fit for the suggested model. Linear regression revealed higher number of medications, more frequent outpatient clinic visits and not experiencing medication adverse effect factors significantly associated with better adherence. The Arabic version of MLG scale is a reliable valid tool to assess adherence among Arabic-speaking communities. Implementing interventions targeting patients not compliant to regular clinic visits and those at higher risk of experiencing medication side effects can greatly enhance medication adherence.

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Medication Non-adherence in Patients with Osteoporosis: Implications for Clinical Pharmacists and Osteoporosis Care Providers

Cited by 6 publications

References 24 publications

<p>Impact of Medication Regimen Simplification on Medication Adherence and Clinical Outcomes in Patients with Long-Term Medical Conditions</p>

<p>Impact of Medication Regimen Simplification on Medication Adherence and Clinical Outcomes in Patients with Long-Term Medical Conditions</p>

Lipid control and its associated factors among patients with dyslipidaemia in Jordan

Translation and validation of the Arabic version of the Morisky, Green and Levine (MGL) adherence scale

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