Beata Jankowska-Polańska1, Natalia Świątoniowska-Lonc2, Piotr Karniej3, Jacek Polański4, Wojciech Tański5, Elżbieta Grochans6. 1. Department of Clinical Nursing, Public Health Department, Wroclaw Medical University, 5 Bartla Street, 51-618 Wrocław, Poland. Electronic address: Beata.jankowska-polanska@umed.wroc.pl. 2. Department of Clinical Nursing, Public Health Department, Wroclaw Medical University, 5 Bartla Street, 51-618 Wrocław, Poland. Electronic address: natalia.swiat@o2.pl. 3. Department of Health Promotion, Public Health Department, Wroclaw Medical University, 5 Bartla Street, 51-618 Wrocław, Poland. Electronic address: Piotr.karniej@umed.wroc.pl. 4. Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, 213 Borowska street, 50-556 Wrocław, Poland. Electronic address: Jacek.polanski@umed.wroc.pl. 5. 4th Military Teaching Hospital, 5 Weigla street, 50-981 Wrocław, Poland. Electronic address: bianko@poczta.onet.pl. 6. Department of Nursing, Pomeranian Medical University in Szczecin, 1 Rybacka street, 70-204 Szczecin, Poland. Electronic address: grochans@pum.edu.pl.
Abstract
BACKGROUND: Medication non-adherence is a global problem and the most common cause of treatment failure. Researchers warn that only one in two patients with chronic conditions adhere to their medication. Therefore, the primary objective of the study was to assess influential factors in adherence to the therapeutic regime in patients with type 2 diabetes and hypertension. The secondary objective was to evaluate medication adherence in patients with hypertension (HT) and/or diabetes (DM) and compare the level of adherence among patients with either diabetes or hypertension. METHODS: The study included 1303 patients divided into three groups according to the type of chronic condition. The Adherence to Refills and Medications Scale (ARMS) was used to assess the level of adherence with pharmacological recommendations. RESULTS: A comparison of adherence between the groups demonstrated that the level of adherence was highest in patients with diabetes alone (17 ± 5.15) and was lowest in patients with co-existing HT and diabetes (19.9 ± 7.51). A single-factor linear regression model analysis showed that the presence of hypertension alone has a positive effect on adherence to medications, while the co-existence of diabetes and hypertension has a statistically significantly negative impact on medication adherence. The sociodemographic predictors of higher adherence included female gender (β = -0.06; p = 0.024), high school education (β = -0.16 and p = 0.001) and being unemployed (β = -0.08; p = 0.0100). CONCLUSION: Patients with co-existing diabetes and HT taking antihypertensive and antidiabetic drugs have the lowest adherence rates, and the co-existence of two chronic conditions is a statistically significant independent determinant of decreased adherence. Variables confirmed in the multiple-factor model as having an independent impact on the level of adherence include the type of condition suffered, female gender, education and professional status. Practical implication. The primary objective is to undertake actions whose aim is to improve adherence in order to enhance patients' functioning, reduce the number of follow-up visits and the hospitalisation rate, and thus limit the economic consequences of treating disease complications.
BACKGROUND: Medication non-adherence is a global problem and the most common cause of treatment failure. Researchers warn that only one in two patients with chronic conditions adhere to their medication. Therefore, the primary objective of the study was to assess influential factors in adherence to the therapeutic regime in patients with type 2 diabetes and hypertension. The secondary objective was to evaluate medication adherence in patients with hypertension (HT) and/or diabetes (DM) and compare the level of adherence among patients with either diabetes or hypertension. METHODS: The study included 1303 patients divided into three groups according to the type of chronic condition. The Adherence to Refills and Medications Scale (ARMS) was used to assess the level of adherence with pharmacological recommendations. RESULTS: A comparison of adherence between the groups demonstrated that the level of adherence was highest in patients with diabetes alone (17 ± 5.15) and was lowest in patients with co-existing HT and diabetes (19.9 ± 7.51). A single-factor linear regression model analysis showed that the presence of hypertension alone has a positive effect on adherence to medications, while the co-existence of diabetes and hypertension has a statistically significantly negative impact on medication adherence. The sociodemographic predictors of higher adherence included female gender (β = -0.06; p = 0.024), high school education (β = -0.16 and p = 0.001) and being unemployed (β = -0.08; p = 0.0100). CONCLUSION:Patients with co-existing diabetes and HT taking antihypertensive and antidiabetic drugs have the lowest adherence rates, and the co-existence of two chronic conditions is a statistically significant independent determinant of decreased adherence. Variables confirmed in the multiple-factor model as having an independent impact on the level of adherence include the type of condition suffered, female gender, education and professional status. Practical implication. The primary objective is to undertake actions whose aim is to improve adherence in order to enhance patients' functioning, reduce the number of follow-up visits and the hospitalisation rate, and thus limit the economic consequences of treating disease complications.
Authors: Rocío Zamanillo-Campos; Maria Jesús Serrano-Ripoll; Joana Maria Taltavull-Aparicio; Elena Gervilla-García; Joana Ripoll; Maria Antonia Fiol-deRoque; Anne-Marie Boylan; Ignacio Ricci-Cabello Journal: Int J Environ Res Public Health Date: 2022-02-08 Impact factor: 3.390