Morisky Medication Adherence Questionnaire Research Articles

Exploring Patient Beliefs and Medication Adherence in the Mediterranean Context: A Cross-Sectional Study in Patients with Cardiovascular Diseases and Cardiometabolic Disorders in Greece-The IACT-Study.

Evidence has shown that poor adherence to vascular medications contributes to a considerable proportion of all cardiovascular disease (CVD) events and mortality. The aim of the present work was to examine patients' beliefs/views that affect their level of adherence to the assigned medical treatment in the context of a multi-center study in Greece. Between July 2022 and April 2023, 1988 patients (1180 females) with established cardiovascular disease or relevant cardiometabolic disorders were chosen from seven medical centers in Greece. The 4-item Morisky Medication Adherence Questionnaire gauged medication adherence and investigated patients' beliefs/views regarding treatment. Among participants, 51.2% showed perfect medication adherence, contrasting with 48.8% displaying poor adherence. Patients with negative medication beliefs were around three times more likely to be non-adherent (OR = 2.73; 95% CI = 2.28-3.28). Non-adherers held concerns about drug efficacy (OR = 2.34; 95% CI = 1.10-4.97) and favored alternative therapies (OR = 2.25; 95% CI = 1.75-2.91). The findings highlight the significance of addressing patient beliefs/views to improve medication adherence. The distinct Mediterranean context, influenced by cultural, socioeconomic, and clinical factors, emphasizes the need for tailored interventions. This underscores the call for contextually sensitive strategies to boost medication adherence and improve health outcomes in this unique region.

Detecting medication non-adherence in schizophrenia: A comparison of different methods among outpatients from a North Indian center.

The rates of medication non-adherence among Indian patients with schizophrenia are high, and its detection poses problems. Comparisons of suitable measures to detect medication non-adherence in schizophrenia from Indian outpatient settings are scarce. This study compared simple and inexpensive methods of detecting medication non-adherence in schizophrenia among outpatients from a tertiary-care center in North India. A longitudinal comparison of two self-reports, the Morisky Medication Adherence Questionnaire and the Drug Attitude Inventory-10, clinicians' ratings employing the Compliance Rating Scale, and clinic-based pill counts was conducted among 70 outpatients with schizophrenia. The rates and detection of medication non-adherence, associations with determinants of treatment non-adherence, and agreement between measures were examined at intake and after six months of follow-up (n = 53). The self-reports had greater ability to detect medication adherence (specificity 41-65%; positive predictive values 25-51%; negative likelihood ratios 0.86-1.14) and moderate ability to detect medication non-adherence (sensitivity 27-65%; negative predictive values 49-69%; positive likelihood ratios 0.78-1.10). They yielded higher medication non-adherence rates, detected changes in medication non-adherence over time, and were associated with the other measures and the well-known correlates of medication non-adherence. Clinicians' ratings and pill counts had high sensitivity (56-90%) but low specificity (35-49%) to detect medication non-adherence. Self-reports are comparatively better screening options for detecting medication non-adherence among Indian outpatients with schizophrenia. However, the sequential use of different measures could lead to better recognition of medication non-adherence.

Evaluation of medication adherence of glaucoma patients during the COVID-19 pandemic

To evaluate changes in the medication adherence of glaucoma patients during the COVID-19 pandemic and the factors influencing medication adherence. This cross-sectional study included a total of 197 glaucoma patients who were followed for at least six months in the Glaucoma Unit of the Ophthalmology Department of Inonu University, Faculty of Medicine. Patients were given a 28-item questionnaire, including the eight-item Morisky Medication Adherence Questionnaire, to evaluate medication adherence. Demographic and clinical data were recorded. P<0.05 was considered statistically significant. Interruption of glaucoma clinic visits during the pandemic was reported by 82 (41.6%) patients. Nonadherence was reported by 56 patients (28.4%) (95% confidence interval: 22.1-34.7). For these patients, the most common reasons for nonadherence were forgetfulness (50%), the inability to receive a prescription for the drug (10.7%) and being busy (10.7%). Factors influencing nonadherence were determined to be younger age, female gender, interruption of glaucoma clinic visits and high-income levels (P˂0.05). Interruption of glaucoma clinic visits during the COVID-19 pandemic and the resulting inability to have medications prescribed resulted in patient nonadherence with medication use.

Effects of telemedicine interventions on essential hypertension: a protocol for a systematic review and meta-analysis

IntroductionEssential hypertension is a major preventable risk factor for early cardiovascular disease, premature death and disability. It has been reported that telemedicine interventions can provide an innovative solution to essential...

Identifying Poor Adherence in Outpatients with Bipolar Disorder: A Comparison of Different Measures.

Objective Unlike schizophrenia, comparisons of different methods of estimating inadequate adherence in bipolar disorder (BD) are scarce. This study compared four methods of identifying inadequate adherence among outpatients with BD. Materials and Methods Two self-reports, the Morisky Medication Adherence Questionnaire (MAQ) and the Drug Attitude Inventory (DAI-10), clinician ratings employing the Compliance Rating Scale (CRS), mood-stabilizer levels, and clinic-based pill counts were compared at intake in 106 outpatients with BD and after 6 months of follow-up ( n = 75). Statistical Analysis Rates of nonadherence were determined for each method. The ability to detect inadequate adherence was based on sensitivity, specificity, positive and negative predictive values (PPV and NPV), and positive and negative likelihood ratios (LR positive and LR negative). Correlation coefficients and Cohen's kappa values were used to determine the agreement between measures. Correlation coefficients were also used to evaluate the determinants of inadequate adherence Results The MAQ and the DAI-10 (cut-off score of two) yielded higher rates of nonadherence (35–47%) than the other methods. They were better at detecting adherence (specificity, 34–42%; PPV, 40–44%; and LR negative, 0.70–0.96) than other measures and had moderate ability to identify nonadherence compared with them (sensitivity, 63–73%; NPV, 54–70%; and LR positive, 1.02–1.16). They were associated with several established predictors of nonadherence. The MAQ and DAI-10 scores and the MAQ and CRS scores were modestly correlated. Multivariate analysis showed that 20% of the variance in the DAI-10 scores was explained by the MAQ scores. Despite their low yield, serum levels had a high sensitivity (88%) and higher accuracy (55%) in identifying inadequate adherence. CRS ratings and pill counts had high sensitivity but low specificity to detect inadequate adherence. Conclusion Self-reports appeared to be the most efficient method of ascertaining inadequate adherence among outpatients with BD. However, since none of the measures were adequate by themselves, a combination of different measures is more likely to maximize the chances of identifying inadequate adherence among these patients.

Medication adherence and blood pressure control among hypertensive patients in Salyan Hospital

Introduction: Hypertension is a chronic medical condition with severe consequences and it remains inadequately managed everywhere. Medication adherence is a critical parameter for achieving strict blood pressure control in patients undergoing antihypertensive therapy. Good medication adherence is also a key factor determining the success of preventive measures for cardiovascular risk reduction. So, we aimed to study the medication adherence and blood pressure control among hypertensive patients of Salyan Hospital.&#x0D; Method: A cross-sectional observational study was conducted in Salyan Hospital. Total of 110 adult hypertensive patients were enrolled in the study. A structured questionnaire i.e. Morisky medication adherence questionnaire (MMAS-8) in Nepali version was used to measure adherence. In addition, WHO validated method of measuring BP, drug type used and type of therapy were also included. Data were entered and analyzed using IBM SPSS.&#x0D; Result: Out of 110 respondents enrolled, less than half of the respondents 45.45% had controlled BP. More than 4/5thwere on monotherapy. BP control in monotherapy was 47.87% and in combination therapy was 45.45%. Patient with high, medium and low adherence were 40.9%, (44.54%) and 14.54% respectively. Level of adherence to antihypertensive drugs was related to BP control (p=0.0004). Most commonly used anti hypertensives were CCBs.&#x0D; Conclusion: There was high prevalence of uncontrolled BP among hypertensive patients in Salyan Hospital. Similarly higher number of patients were on monotherapy. But BP control in monotherapy and combination therapy was similar. Higher number of patients were non-adherent. The relation between BP control and medication adherence was statistically significant. So the causes of poor BP control and poor adherence should be explored and addressed in each doctor-patient encounter.&#x0D; Keywords: Blood Pressure, Medication adherence, Morisky medication adherence questionnaire (MMAS-8)

Do the stress levels affect the quality of life and treatment adherence in hospitalized medically ill patients?

Background and Objectives: Stress can be experienced in day to day life and can be usually resolved by effective coping mechanisms of a person and can also prove beneficial provided the loss of equilibrium is corrected. However, some life events may disturb the steady state to an extent where the person is not able to overcome the stress. In this study, we aimed to examine the relationship between perceived stress levels, quality of life and treatment adherence in patients hospitalized with medical illnesses. 400 patients admitted in the general medicine ward were approached and, after obtaining informed consent, perceived stress, quality of life and treatment adherence was assessed using the Perceived Stress Scale (PSS-10), World Health Organization Quality of Life scale-Bref version and Morisky Medication Adherence Questionnaire. Socio demographic and clinical features were also assessed and relationship between all the variables was studied.

Patients’ adherence to topical antiglaucoma medications in a tertiary care hospital

Abstract Objectives Adherence to glaucoma medications is a central factor to control intraocular pressure and manage glaucoma effectively. This study aims to assess the level of adherence of glaucoma patients to ocular hypotensive agents and determine factors contributing to non-adherence in the Aseer region. Methods This was a single-centre, prospective cross-sectional study carried out in Aseer Hospital, Saudi Arabia. Data were collected through a customized questionnaire adapted from the Morisky, Green and Levine Medication Adherence Questionnaire (MGLS). Key findings Of the 102 glaucoma patients, 63 (61.8%) were non-adherent to their glaucoma medications. About 48 (76.2%) of them reported that they have no background information about glaucoma. Older participants (37, 58.7%; &amp;gt;50 years) showed a low adherence level compared with the younger individuals. Contributing factors to non-adherence include forgetting the dose time (32, 50.8%), illiteracy (31, 49.2%; P = 0.313), economic problems (26, 41.3%; P = 0.286) and lack of information about prescribed medications (15, 23.8%; P = 0.188). Conclusions No significant relationship was found between medication adherence and patient’s demographic data or their background knowledge about glaucoma. Despite the need for improving the glaucoma patient’s knowledge of their disease and the importance of medication adherence, an additional strategy as alerts by smartwatches should be encouraged to improve the adherence level.

Clinical Correlates of Treatment Adherence and Insight in Patients with Schizophrenia

Aim: The aim of this study was to assess clinical correlates of treatment adherence and insight in patients with schizophrenia.&#x0D; Methods: That cross-sectional study included 229 outpatients with schizophrenia who were admitted to the Psychiatry Outpatient Clinic of Health Sciences University Dışkapı Yıldırım Beyazıt Training and Research Hospital. All participants were administered a socio-demographic form, Morisky Medication Adherence Questionnaire, Schedule for Assessing the three components of insight, Brief Psychiatric Rating Scale, Positive and Negative Symptoms Rating Scale, Calgary Depression Scale for Schizophrenia, and Global Assessment of Functioning Scale. Collected data were analyzed with descriptive statistics, Pearson Correlation Analysis, and logistic regression analysis. &#x0D; Results: Poor treatment adherence was associated with male gender, lower insight level, more severe psychotic symptoms, and lower functionality level. The insight score was negatively correlated with the severity of psychotic symptoms, duration of the disorder, and mean antipsychotic dose; but positively correlated with advanced age of onset and higher functionality level. The logistic regression analysis revealed that functionality level was more predictive of poor medication adherence.&#x0D; Conclusion: Poor treatment adherence and lower insight level were closely associated with more severe clinical symptoms and lower functionality level. It was noteworthy that adherence and insight levels both showed a high predictivity for the wellbeing of the patients. Therefore, psychotherapeutic interventions should be implemented to increase treatment adherence and insight in schizophrenia even if the psychotic symptoms show resistance. Further research is needed to clarify clinical associations of the treatment adherence and insight level in patients with schizophrenia.

Anxiety and depression versus treatment adherence among type II diabetes mellitus patients at government tertiary care institution, Madurai, Tamil Nadu

Background: Global, Indian and Tamil Nadu prevalence of diabetes mellitus (DM) was 8.5%, 7.7% and 10.4% respectively. Prevalence of anxiety or depression was higher among diabetics in comparison to general population. Treatment adherence was related to prevention of mortality and morbidity. Currently anxiety or depression are not looked for and data is scarce regarding the burden of anxiety or depression among type II DM patients. The objectives of the study were to estimate proportion(s) of type II diabetes patients having anxiety or depression; having treatment adherence and to determine the association between anxiety or depression and treatment non adherence.Methods: We did cross sectional study among type II DM patients at Government Rajaji Hospital, Madurai and did consecutive sampling. The sample size of the study was 96 which was collected diet and exercise details. It used Morisky medication adherence questionnaire and hospital anxiety and depression scale to measure medication adherence and anxiety and depression. The study was calculated proportions and odds ratio with confidence intervals, obtained Ethics clearance and referred participants who had anxiety or depression to Psychiatrist.Results: Proportion of anxiety or depression was 36.5% (27.3 to 46.4). 55% had adequate diet adherence, 48% had adequate exercise adherence, 68% had adequate medication adherence, 40% (29.8 to 50.1) had adherence to all the three. Odds of anxiety or depression among poor treatment adherents was 4.1 (1.6 to 11.4) times more in comparison to their counterparts.Conclusions: Proportions of anxiety or depression and treatment adherence were 37% and 40% among diabetics. Anxiety or depression could be a potential risk factor for poor treatment adherence. We recommended screening for anxiety and depression in the follow up of diabetics.

Assessment of Non-Adherence to Oral Metformin and Atorvastatin Therapies: A Cross-Sectional Survey in Piedmont (Italy).

IntroductionIt is not possible to recover from chronic diseases; however, a healthy lifestyle and correct adherence to therapy can avoid complications and co-morbidities. The aim of this study was the cross-sectional evaluation, by means of a questionnaire, of real-world data on the prevalence of non-adherence to metformin and atorvastatin oral therapies in a sample of patients that attend community pharmacies in the Piedmont Region. The secondary aim was to evaluate the presence of correlations between non-adherence and a number of variables detected by the questionnaire.Materials and MethodsData were gathered from face-to-face interviews in six community pharmacies in Piedmont. The questionnaire was divided into two sections: the first included the Morisky, Green and Levine Medication Adherence Questionnaire (MAQ) (to assess therapy adherence); the second included questions on gender, age, level of education and the pharmacy in which the questionnaire was administered. Comparisons between proportions and mean values were performed using the χ2 test. Modified Poisson regression with robust standard errors was used for multivariate analysis. The level of significance was fixed at 0.05, CI at 95%.ResultsThe sample analysed was composed of 408 subjects (receiving either metformin or atorvastatin). According to MAQ, 62 patients were non-adherent (15% of the total cohort). Crude and multivariate analysis did not show any statistically significant correlation between gender, age, level of education and non-adherence. It emerged that there was a correlation between non-adherence and being a customer of two of the pharmacies involved [PR = 3.31 (p=0.028) and PR = 3.11 (p=0.027)].ConclusionsCommunity pharmacies can be an appropriate setting to identify non-adherent patients. Therefore, healthcare professionals could realize an integrated and structured intervention to improve adherence. However, MAQ could underestimate the number of non-adherent patients. Further studies to test the association between non-adherence prevalence and being the customer of a specific pharmacy should be performed.

Medication Adherence Analysis of Type 2 Diabetes Mellitus Patients

Adherence has an important role in therapy management in patients with type 2 Diabetes Mellitus. This research is to identify and analyze factors related to medication adherence. The design used in this study was a descriptive-analytic design with a cross-sectional approach. The population is type 2 Diabetes Mellitus sufferers of Prolanis Group in Primary Health Care Facilities in the Ponorogo Regency. A sample of 180 respondents was taken by purposive sampling technique. Variable X includes age, gender, education, occupation, income, and length of suffering. Variable Y was medication compliance with type 2 Diabetes Mellitus patients. Data collection used a Morisky Medication Adherence (MMAS-8) questionnaire and was analyzed using the Chi-Square test with a significant level of α &lt;0.05. From the results of the study, it was found that the factors of age, sex, education, employment, income and duration of suffering had a significant relationship with medication adherence for patients with type 2 diabetes mellitus. It is expected that health services develop family and community-based service management. Researchers are further advised to develop programs to improve medication adherence.

Selected psychological aspects and medication adherence in oncological patients.

ObjectiveThe aim of this study was to analyze the relationships between selected psychological features and adherence to therapy in oncological patients.MethodsThe study included 102 patients of oncological clinics, 66.67% of whom were female. The average (SD) age of the study subjects was 49.15 ± 18.16 years old. The following tools were used: Morisky Medication Adherence Questionnaire (MAQ‐4), Multidimensional Health Locus of Control, Coping Inventory for Stressful Situations, Personal Values Inventory (LWO), and a study‐specific survey questionnaire.ResultsHigh MAQ‐4 scores were declared by 39.2% of the subjects, medium scores by 32.3% and low scores by 28.5%. The values were higher in female patients (P = .23), younger subjects (P < .001), and in individuals with higher education (P = .03). The greatest adherence was observed in subjects who placed their locus of control in chance (P = .022). Significant relationships were identified between the level of medication adherence and the use of avoidance strategies of coping with stress (P = .037), including the willingness to engage in social relationships (P = .04). It was demonstrated that the risk of noncompliance in the analyzed group was associated with a lower assessment of appearance (OR = 0.75) and health (OR = 0.78) on the scale of values.ConclusionMedication adherence in oncological patients is related to the health locus of control, strategies of coping with stress, and the value assigned to appearance and health.

Facteurs associés à la non-observance thérapeutique chez les diabétiques de type 2 : première enquête algérienne

Non-adherence in patients with type 2 diabetes is a frequent phenomenon with important impact in terms of management of this disease. The aim of this study was to assess the level of medication adherence and to identify the factors associated with non-adherence in type 2 diabetic patients. A cross-sectional study was conducted in type 2 diabetic patients at the endocrinology and diabetology department of University Medical Center of Sidi Bel Abbes (Algeria) in 2017. Medication adherence was determined using a morisky 8-Item medication adherence questionnaire. A logistic regression was used to identify factors associated with non-adherence. The study enrolled 403 type 2 diabetic patients. The mean age was 60 years and sex-ratio was 0.8. Medication non-adherence rate was 31.3% (95% CI: 26.8-35.8%). The factors significantly associated with non-adherence in multivariate analysis were: health insurance status, self-monitoring of blood glucose, disease duration, education level and need for information on diabetes. Our study had demonstrated a low adherence in patients with type 2 diabetes. The results suggest that implementation of a therapeutic education program could be important in management of diabetes.

Investigation of medication adherence and reasons for poor adherence in patients on long-term glaucoma treatment regimes.

ABSTRACTPurposeLong-term treatment adherence for a chronic asymptomatic condition is a demanding task for many patients. Treating progressive glaucoma can also be confounding for physicians, particularly when management relies on assumption of adherence. This study investigated associations between self-reported adherence and frequency of medication changes due to glaucoma progression.MethodsA total of 128 participants with primary open angle glaucoma were recruited from glaucoma clinics in Flinders Eye Center, South Australia, and completed confidential questionnaires. Information was obtained regarding beliefs about glaucoma and their treatment. Adherence was assessed using the four-item Morisky, Green and Levine Medication Adherence Questionnaire (MGL). Medical records were analyzed for the number of medication changes, due to glaucoma progression.Results Adherence to topical glaucoma medication was categorized as ‘high’ in 41.4% (Morisky, Green and Levine (MGL). Data were analyzed for behaviors affecting adherence, history of adherence, and reasons for changed adherence. Chi-squared test demonstrated that there was no significant association noted between adherence and changes in medication regime (χ2 (2,128)=0.968, P=0.915); however, a significantly lower adherence was detected if participants had difficulties with their drop regime (χ2 (2,128)=7.24, P=0.027) or had help with drop insertion (χ2 (1,128)=9.77, P=0.008).ConclusionThis study revealed a higher rate of non-adherence than has previously been demonstrated in other studies. This may be attributed to the unique design of the confidential questionnaire and the independent and sympathetic questioning techniques used. Further work to develop a specific glaucoma medication adherence questionnaire would be valuable to enhance glaucoma management.

SAT-234 EVALUATION OF MEDICATION ADHERENCE IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Chronic kidney disease (CKD) is a public health problem around the globe with an increasing incidence and prevalence, poor outcomes, and high cost. In CKD, adherence with medication is a key component of effective disease management. This study aimed to evaluate the medication adherence of the patients with CKD, associated with their demographic characteristics. A prospective, cross-sectional, questionnaire based study was conducted in National Kidney Center, a specialty hospital, in Kathmandu, Nepal. Based on inclusion and exclusion criteria, a total of 147 CKD patients were interviewed using self-designed, semi-structured questionnaire to get information about adherence to medication and demographic details of the patients. Morisky medication adherence questionnaire was used to calculate overall adherence. Based on the Morisky scale for medication adherence, the study found out that 28.6%, 35.3% and 36.1% of patients had high, medium and low adherence respectively. The mean age of the patient was found to be 46.22 years (SD=14.564). The study found that majority of the patients 57.1% had Hypertension, 6.1% had Diabetes, 2.7% had Edema, 18.4% had both Hypertension and Edema, 7.5% had both Hypertension and Diabetes, 2% had all of them as comorbid condition and 6% were in non-comorbid condition.Regarding the education level, which seems to be one of the strong predictors for nonadherence; 29.4% were illiterate, and 15% primary level, 11.5% lower secondary level, 17.7% secondary level, 16.9% high school level, and 9.5% were graduated. Socio-demographic characteristics of the patient Age range of the patientTabled 1Gender of patientMale9463.9Female5336.1Marital statusMarried12786.4Unmarried2013.6Smoking habitYes3523.8No11276.2Alcohol intakeYes3523.8No11276.2EducationIlliterate4329.3Primary2215Lower secondary1711.5Secondary2617.7High school2517Graduate149.5Profession of patientsLabor128.2Civil53.4Service3423.1Unemployed7349.7Retired106.8Others138.8Year of CKD occurrenceLess than 1117.51-5 years8859.95-10 years3725.1More than 10 years117.5Weekly1510.1Twice a week11175.5Once a month64.1Above one month1510.2Monitor of CKDHypertension8457.1Diabetes96.1Edema42.7Hypertension and edema2718.5Hypertension and diabetes117.5All-of-above32.0None of above96.1 Open table in a new tab A significant percentage of the patient self-reported non- adherence to medication. Education level of the patient seems to be one of the key elements in medication adherence. CKD is increasingly recognized as a global public health problem which needs to be address effectively, along with that implementing helpful health literature program in developing countries is in great need.

Application effect of timing theory on self-management and medication adherence in patients with percutaneous coronary intervention

Objective To investigate the effect of intervention theory based on timing theory on self-management behavior and medication compliance of patients with percutaneous coronary intervention (PCI) . Methods A total of 126 patients who underwent PCI in People's Hospital of He'nan Province in 2018 were enrolled, including 67 who had PCI from April to June in 2018 in the experimental group and 59 who had PCI from January to March in 2018 in the control group. Patients in the control group received routine nursing intervention. The patients in the experimental group were treated with an intervention program based on timing theory. The Coronary Heart Disease Self-Management Scale and the Morisky Medication Adherence Questionnaire were used to compare the effects of the intervention. Results After intervention, the scores of daily life management (17.11±3.62) , bad habit management (16.33±4.36) , disease knowledge management (17.11±3.68) , symptom management (14.25±4.15) , first aid management (13.55±4.27) , treatment compliance management (11.13±3.62) and emotional cognitive management (15.69±4.25) in the experimental group were higher than the control group with (14.57±3.69) , (14.17±3.88) , (14.36±3.56) , (12.34±4.46) , (10.41±3.89) , (7.69±4.14) , (13.23±4.32) respectively, and the differences were statistically significant (t=3.895, 2.921, 4.250, 2.489, 4.293, 4.976, 3.217; P<0.05) . After the intervention, the scores of the medication adherence questionnaire in the experimental group was (6.35±1.12) , and the control group was (5.92±1.17) . The difference between the two groups was statistically significant (t=2.106, P=0.037) . Conclusions Timing theory can improve the self-management behavior and medication compliance of PCI patients, and can be applied in clinical practice. Key words: Medication adherence; Percutaneous coronary intervention; Timing theory; Self-management

Medication adherence and its associated factors among hypertensive patients in a tertiary health facility in Minna, North Central Nigeria

Background: Poor adherence to anti-hypertensive medications has caused increased cardiovascular risk and death. Nigerians have been shown to have a worse prognosis from hypertension, poor blood pressure control, and increased risk of complications arising from poor adherence to anti-hypertension medication. Objective: The objective of this study was to assess anti-hypertensive medication adherence and associated factors among hypertensive patients attending a tertiary health facility in Niger State, Nigeria Method: A hospital based cross-sectional study was conducted by administering Morisky medication adherence questionnaire to 237 study participants between February and May 2018.

Adherence to treatment in patients undergoing dialysis

Background: Chronic Kidney Disease (CKD) is a silent disease that is frequently diagnosed in advanced stages. The prevalence and incidence of chronic kidney disease (end-stage renal disease) are continuously increasing, particularly in elderly patients. Poor adherence to complex multimodal therapies is a widely recognized problem in the daily care of dialysis patients, contributing to excess morbidity and mortality of this population. Aims and objectives was to assess the adherence to medications among patients undergoing haemodialysis and to explore the factors affecting non adherence.Methods: After obtaining approval from Institutional Ethics Committee, a prospective observational study was carried out among 150 patients, who were on dialysis in a tertiary care hospital, Hassan. An eight item Morisky Medication adherence questionnaire was used to assess medication adherence. Chi-square test applied to assess statistics.Results: Adherence levels were 28%, 42% and 30% for high, medium and poor adherence respectively. The overall prevalence of non-adherence among respondents was 30%. Among them 77.77% were males, 44.44% belonged to age group of 41-60 years, 40% illiterate, 60% employed, 51.11% of patients with smoking and alcoholic habits were not adherent to Dialysis. Other reasons contributing to non-adherence to treatment were forget fullness (86.66%), inadequate knowledge about side effects (80%), unhappy clinical visits (71.11%) and lack of assistance (48.88%).Conclusions: In this study patient showed moderate adherence. This emphasizes the need for constant motivation and education at frequent intervals to ensure better adherence.

Assessment of knowledge and adherence to therapy among chronic kidney disease patients attending nephrology department of tertiary care hospital, Kurnool city, Andhra Pradesh

Background: High level of adherence to prescribed medication is very essential to obtain the desired outcomes in chronic kidney disease (CKD) patients. Non-adherence to medication has been associated with increased morbidity, mortality, and higher costs of care. Objectives: The objectives of this study were as follows: (1) To assess adherence to medications in CKD patients, (2) to know the patient’s knowledge regarding treatment, and (3) to study factors associated with nonadherence to medications in CKD patients. Materials and Methods: A cross-sectional study was conducted in the nephrology department of a tertiary care hospital. Patients (n = 206) aged >18 years, diagnosed with CKD and on treatment for >3 months were interviewed. Permission from ethical committee was taken and informed consent was obtained from the study subjects before start of the study. Morisky Medication Adherence Questionnaire (MMAQ) was used to assess overall adherence. A high score indicates poor adherence. Results: Of 206 patients, 1.46% (3) were Stage 1, 2.91% (6) were Stage 2, 11.17% (23) were Stage 3, 15.53% (32) were Stage 4, and 68.93% (142) were Stage 5 of CKD according to the National Kidney Foundation 2002 guidelines. Using the MMAQ, high, medium, and low adherence was reported in 23.30%, 42.23%, and 34.47% of patients, respectively. An average number of medicines taken in a day by each patient was 5.75 ± 0.707. Common causes of non-adherence were forgetfulness (71.51%), high cost of medicine (24.05%), and large pill burden (18.35%). Conclusions: Non-adherence remains a major obstacle in the effective management of CKD population. Periodic counseling about the importance of medication adherence to the patients and caregivers is essential to improve adherence.