Factors affecting medication adherence among chronic obstructive pulmonary disease patients attending at teaching Hospital, Chitwan

ABSTRACT

Background: Medication adherence is crucial for optimizing clinical outcomes in chronic obstructive pulmonary disease (COPD) patients because non-adherence possess significant burden in health and economy. Patients’ medication adherence is influenced by numerous factors. Objective: The objective of this study was to identify the factors affecting medication adherence among COPD patients attending at teaching hospital, Chitwan. Materials and Methods: A descriptive cross-sectional study was carried out among 121 clinically diagnosed COPD patients attending at a teaching hospital, Chitwan. Non-probability purposive sampling technique was used to select patients for the study. Ethical approval was taken from Chitwan Medical College – Institutional Review Committee and informed consent was obtained from patients. Pre-tested semi-structured interview schedule and a standardized tool “Morisky Medication Adherence Scale, 2008" were used to gather the data by the researcher from November 16, 2016, to December 15, 2016. Bivariate and multinomial logistic regression analyses were performed to analyze the data. Results: Findings of the study revealed that out of 121 patients, 55.4% had medium level, 28.9% had a high level, and 15.7% had a low level of medication adherence. Bivariate analysis showed that patients’ level of medication adherence was significantly associated with an understanding of disease condition from family members (P = 0.03), support from neighbors as needed (P = 0.02), having own monthly income (P = 0.04), and affordability of medication cost (P = 0.02). Multinomial logistic regression analysis identified that patients who can afford the cost of medication (odds ratio [OR] 6.39, 95% confidence interval [CI] 1.27–32.11), had family understanding about disease condition (OR 11.18; 95% CI 1.76–70.66), get support from neighbor as needed (OR 11.92; 95% CI 2.39–59.34), and had accessible to health facilities at <30 min distance (OR 0.10; 95% CI 0.02–0.55) were more likely to have high level of medication adherence. Conclusion: Only one-third of the COPD patients have a high level of medication adherence. Hence, local health-care planners need to organize the educational program on medication adherence for COPD patients by considering the notable factors to enhance their quality of life.