Comparing Medication Non-adherence in Cardiovascular Disease Patients at Public and Private Hospitals in Peshawar: A Cross-Sectional Study of Prevalence and Contributing Factors.

Abstract

Introduction The incidence of cardiovascular diseases continues to increase, becoming one of the leading causes of mortality globally. The proper use of medication can greatly reduce the death rate by slowing the progression of the disease. Yet, many patients struggle with following their medication regimen due to various reasons. Effective treatment management relies on patients'self-care and understanding of their illness and medications, which can impact their adherence to taking their prescribed drugs.The objective of the study was to determine the prevalence of medication non-compliance among patients in two public and private tertiary care hospitals in Peshawarand to identify the factors that contribute to this behavior. Material and methods A comparative cross-sectional study design was employed for the research. The study was conducted at Hayatabad Medical Complex and Rehman Medical Institute in Peshawar, as these two hospitals provide care for a significant proportion of cardiovascular disease patients in the area. To assess adherence, a quantitative scale was devised with scores of 8 considered high adherence, scores between 6 and 7 considered medium adherence, and scores below 6 considered low adherence. The factors impacting medication non-adherence were analyzed using a self-administered questionnaire, which was developed following a preliminary study conducted at both hospitals. Results In total, 168 eligible patients from the two hospitals were given the questionnaire. Out of these patients, 107 (63.7%) were male, and 61 (36.3%) were female, with ages ranging from 19 to 84 and a mean age of 55.33. The level of medication adherence was calculated among the participants, with 20.2% reporting high adherence, 22.6% reporting medium adherence, and 57.1% reporting low adherence. The results showed that monthly income (p = 0.006), the presence of co-morbidities (p = 0.002), and the fear of addiction to medication (p = 0.048) were the main factors influencing medication adherence. In regression analysis with high adherence as the reference category and a 95% confidence interval, hospital affiliation was found to be significantly associated with adherence levels. Conclusions The study found that medication adherence among cardiovascular disease patients in private tertiary care hospitals is generally high. However, the level of adherence was seen to be impacted by the patient's monthly income. In light of this, the government should implement programs to reduce the cost of healthcare provision and increase affordability for patients.