Assessing Individual Medication Adherence among Chronic Kidney Disease Patients: A Multi-centered Study
Tengku Nur Izzati Tengku Abd Kadir
Center of Quality Medicine Management, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia and Department of Pharmacy, Hospital Sultanah Nur Zahirah, Ministry of Health, Kuala Terengganu, Terengganu, Malaysia.
Farida Islahudin *
Center of Quality Medicine Management, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Muhammad Zulhilmi Abdullah
Center of Quality Medicine Management, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Norkasihan Ibrahim
Department of Pharmacy, Hospital Kuala Lumpur, Ministry of Health, Kuala Lumpur, Malaysia.
Pau Kiew Bing
Department of Pharmacy, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia.
*Author to whom correspondence should be addressed.
Abstract
Aims: This study aims to identify differences in outcomes of assessing overall versus individual adherence and factors associated with adherence to medication therapy in chronic kidney disease patients.
Study Design: This is a cross-sectional study.
Place and Duration of Study: Nephrology Clinic, Universiti Kebangsaan Malaysia Medical Centre and Ministry of Health Hospitals between June 2018 and June 2019.
Methodology: We included 491 patients (243 men, 248 women); average age of 54.5 (±14.6) years with chronic kidney disease and prescribed at least one medication, using a validated questionnaire.
Results: Patients were prescribed an average of 7.0±2.4 medications. Majority were categorized as adherent (n=404, 82.3%) based on an overall assessment. In contrast, only 27.5% (n=135) were adherent when medications were assessed individually. Based on individual medication assessment, a multivariate logistic regression demonstrated patients aged >55 years were 2.3 times more likely to be adherent toward medicines (P=.001). Those with <3 comorbidities and <7 medications increased the odds of adherence by 2.1 (P=.002) and 2.2 (P=.001) times respectively. Having a drug knowledge score >80% increase the odds of adherence by 8.7 times compared to their counterparts (P<.01).
Conclusion: Potential strategies for targeted management should be developed in order to remove barriers towards medication adherence in chronic kidney disease patients.
Keywords: Adherence, chronic kidney disease, medication, factors.