Cost-related medication nonadherence in the Mekong Delta, Vietnam.

Abstract

Cost-related nonadherence (CRN) to prescription medication has been shown to affect healthcare outcomes. While CRN has been reported in many countries globally, it has not been fully characterized in Vietnam. This study was conducted to determine CRN rates and factors associated with CRN among pharmacy customers in the Mekong Delta, Vietnam. A cross-sectional research design used printed self-administered questionnaires in Vietnamese distributed to customers of private pharmacies and pharmacy chains in the Mekong Delta from January to March 2024. Of the 1546 respondents, 49.9% reported experiencing CRN, with the most commonly reported action being delaying filling a prescription (38.2%). Compared to participants aged ≥65 years, those aged 18-44 years were 2.5 times more likely to report CRN, with an adjusted odds ratio (aOR) of 2.51 (95% confidence interval [CI]: 1.55-4.06). Poorer self-reported health status was a strong predictor of CRN (aOR = 3.72; 95% CI: 2.32-5.95) compared to better self-reported health status. Having more prescriptions was a strong predictor of CRN (aOR = 2.25; 95% CI: 1.70-2.98) compared to having fewer prescriptions. The presence of chronic conditions was associated with being 2.5 times more likely to report CRN (aOR = 2.46; 95% CI: 1.71-3.55) compared to those without chronic conditions. Nearly half of the participants experienced CRN. The findings of this study showed that implementing public health initiatives, such as routine care, in-person and telephone counseling, and educational programs by pharmacists, is necessary to reduce CRN among the population of the Mekong Delta. More studies are needed to help inform policymakers on how to reduce CRN and improve access to medications.