Medication Adherence and Treatment Satisfaction in Chronic Obstructive Pulmonary Disease and Bronchial Asthma

Abstract

Adherence to treatment is one of the most important factors that guarantee the success of the asthma and COPD treatment.4 Also patient satisfaction is an important measure that should be included in healthcare evaluations, it is important to know how patients feel about treatment regimens; such information may assist the definition of optimal medical care for the patients.60 This present study was conducted on (487) patients at Sadr Elabbassia Chest Hospital from April 2014 till March 2015, COPD patients were (238) and were diagnosed according to GOLD 2014 guidelines7, while asthmatic patients were (249) and diagnosed according to GINA 2014 guidelines26, This study was done to evaluate medication adherence and treatment satisfaction. Evaluation of medication adherence among these patients was done by the application of validated Arabic version of Morisky medication adherence scale (MMAS) and treatment satisfaction by Treatment Satisfaction Questionnaire Medication (TSQM1.4). From the present study, the following results were obtained: 1-COPD patients were less adherent to their medications than asthmatics. 2-Effectiveness of treatment, side effects of medication as well as global satisfaction were significantly lower among COPD patients in comparison to asthmatics. 3-COPD patients with recurrent hospital admission were significantly more adherent to medications, whereas the treatment satisfaction among COPD patients and asthmatics as well as the adherence to medications didn't differ significantly between those with recurrent and non recurrent hospital admission. 4-Asthmatics with no co-morbidity were more adherent and satisfied with their medications than those with co-morbid medical conditions. 5-Comorbidity among COPD patients didn't affect the treatment adherence nor the satisfaction with their medications. 6-Asthmatics with subjective treatment regularity were more satisfied with their medications than those with subjective treatment regularity. 7-Subjective treatment regularity didn’t affect the treatment adherence nor the satisfaction with medications among COPD patients. 8-COPD patients who were subjectively satisfied with their medications were more adherent to their treatment, whereas the subjective treatment satisfaction didn’t affect the adherence to medications among asthmatic patients. 9-In COPD group: - There were significant positive correlations between TSQM effectiveness and TSQM Side effects, TSQM Convenience, TSQM Global satisfaction, MMAS Total subscales, age and general medication duration. -There was negative correlation between TSQM effectiveness with current medication duration. -There were significant positive correlations between TSQM-Side effect, TSQM-Convenience, TSQM- Global satisfaction, MMAS Total subscales and FEV1/ FVC%. - There were significant positive correlations between TSQM-Convenience and TSQM- Global satisfaction and MMAS Total subscales. -There were negative correlations between TSQM- Convenience and duration of current medication and FEV1/ FVC%. - There was significant positive correlation between TSQM-Global and MMAS total subscales. - There was negative correlation between TSQM-Global satisfaction and duration of current medications. -There were significant negative correlations between total MMAS and cigarette smoking index & FEV1/ FVC. 10- In asthma group there were significant positive correlations between all TSQM subscales and MMAS subscales as well as between TSQM subscales. 11-MMAS scale was chiefly affected by TSQM convenience, urban residence and male sex among COPD patients while it was affected by TSQM convenience only among asthmatics. 12-TSQM global satisfaction was chiefly affected positively by TSQM effectiveness, but was affected negatively by FEV1/FVC % and age among COPD patients and among asthmatics global satisfaction was affected positively by of TSQM effectiveness, and negatively affected by FEV1/FVC % and long duration of Chest medication.

13-TSQM convenience was chiefly affected positively by TSQM effectiveness, age, male sex, FEV1/FVC % and urban residence, and affected negatively by long duration of Chest Medication among COPD patients, while among asthmatics convenience was affected positively by TSQM effectiveness, male sex and FEV1/FVC%.

14-TSQM side effects were chiefly affected positively by TSQM effectiveness score and FEV1/FVC among COPD patients, among asthmatics side effects were affected positively by TSQM effectiveness, male sex, urban residence and FEV1/FVC%.

15-TSQM effectiveness was chiefly affected positively by age, male sex, urban residence and FEV1/FVC %, while effectiveness was affected negatively by long duration of chest medication among COPD patients, among asthmatics effectiveness was affected positively by age, male sex, urban residence and FEV1/FVC %.