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Abstract
The evaluation of medicines burden from the patients’ perspectives is a crucial endeavor to identify any barriers that may hinder achieving optimal health outcomes. Therefore, this study was designed, firstly to identify the prevalence of medication-related burden among geriatrics and factors influencing this burden. Secondly, to determine the prevalence of medication adherence and the correlation between the burden and adherence. A cross-sectional study was performed using Living with Medicines Questionnaire version-3 (LMQ-3) and Adherence to Refills and Medications Scale (ARMS) questionnaire. Four hundred and fifty patients attending primary healthcare centers were invited to participate, and 424 (94.2%) agreed. Data were collected via face-to-face structured interviews. The vast majority of respondents (97.4%; 95% CI: 95.3–98.6) perceived to suffer from minimum (35.4%) to moderate (62.0%) degrees of medicine burden. The median (IQR) LMQ overall score was 112 (21) indicating a moderate burden. LMQ-3 overall scores revealed a significant trend toward higher perceived burden among respondents aged ≥ 75 years, males, non-Kuwaitis, residents in Al-Farwaniyah and Al-Jahra governorates, using oral and nonoral formulations, paying prescription charges, and needing support with using medicines (p <0.05). Almost 55% (95% CI: 49.8–59.5) of respondents were nonadherent to their medications. The median (IQR) ARMS overall score was 20 (7.0) indicating low adherence to medications. There was a significant positive correlation between LMQ-3 and ARMS scores (p<0.001) showing that the higher the medications burden the lower the level of medication adherence. The key findings of this study underscore the need for multifaceted interventions that could be targeted at the identified problems to reduce medication burden and improve medication adherence.
Highlights
The burden of noncommunicable chronic diseases (NCDs) is rapidly increasing globally
Despite global efforts to reduce the burden of these NCDs (WHO, 2013), the major emphasis of the clinical practice guidelines and healthcare practitioners is to achieve the desired clinical therapeutic outcomes for each NCD that may lead to better disease management, and may generate a drive toward prescribing multiple medications that are becoming burdensome to patients (May et al, 2009; Eton et al, 2012)
The present study appears to be the first attempt in Kuwait, and probably in the Middle East and North Africa (MENA) region to assess medicationrelated burden (MRB) from the perspective of geriatric patients living with NCDs using the Living with Medicines Questionnaire version-3 (LMQ-3)
Summary
The burden of noncommunicable chronic diseases (NCDs) is rapidly increasing globally. The four major chronic diseases accounting for 79% of NCD deaths, include, cardiovascular diseases, cancers, respiratory diseases, and diabetes (WHO, 2018). Despite global efforts to reduce the burden of these NCDs (WHO, 2013), the major emphasis of the clinical practice guidelines and healthcare practitioners is to achieve the desired clinical therapeutic outcomes for each NCD that may lead to better disease management, and may generate a drive toward prescribing multiple medications that are becoming burdensome to patients (May et al, 2009; Eton et al, 2012). It was reported that patients with multiple NCDs are often exposed to a fragmented care approach, and trying to cope with various recommendations and complex medication therapy regimens that adversely affect their quality of life (QoL) (Tinetti and Fried, 2004; Boyd et al, 2005)
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