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Comparing Medication Non-adherence in Cardiovascular Disease Patients at Public and Private Hospitals in Peshawar: A
Azhar Saeed1, Qazi Kamran Amin2, Rida Saeed3
1Internal Medicine, Stockport National Health Service (NHS) Foundation Trust, Manchester, GBR.
Insights
Medication adherence is low for many cardiovascular disease patients, influenced by income and co-morbidities. Improving affordability and patient education is crucial for better treatment outcomes.
Area of Science:
- Cardiology
- Public Health
- Health Economics
Background:
- Cardiovascular diseases (CVDs) are a leading global cause of mortality.
- Effective medication management is vital for slowing disease progression and reducing deaths.
- Patient self-care and understanding of illness/medications significantly impact adherence.
Purpose of the Study:
- To determine the prevalence of medication non-compliance in CVD patients.
- To identify factors contributing to non-adherence in Peshawar hospitals.
- To compare adherence between public and private tertiary care settings.
Main Methods:
- A comparative cross-sectional study design was used.
- Data collected from 168 patients at two tertiary care hospitals in Peshawar.
- Medication adherence assessed using a quantitative scale and a self-administered questionnaire.
Main Results:
- Over half of patients (57.1%) reported low medication adherence.
- Monthly income (p=0.006), co-morbidities (p=0.002), and fear of addiction (p=0.048) significantly impacted adherence.
- Hospital affiliation showed a significant association with adherence levels.
Conclusions:
- Medication adherence is generally higher in private tertiary care settings.
- Patient monthly income is a key factor influencing medication adherence.
- Government initiatives to reduce healthcare costs and improve affordability are recommended.
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 Peshawar and 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.
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