EFFECTS OF SOCIOECONOMIC AND CLINICAL FACTORS ON TREATMENT ADHERENCE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASES PATIENT: FOCUS ON INHALATION THERAPY
DOI:
https://doi.org/10.22159/ajpcr.2024v17i10.51542Keywords:
COPD, Drug adherence, Kuppuswamy scale, inhalerAbstract
Objective: Chronic obstructive pulmonary disease (COPD) refers to a persistent blockage of airflow that requires bronchodilator medication for the rest of one’s life. The goal of the treatment can only be met when the patient is adhering to the prescribed medicine. This study identifies and analyzes how clinical and socioeconomic factors affect COPD patients’ drug adherence to given therapy. The impact of our findings will reduce socioeconomic inequality in COPD management which will improve adherence to drugs and overall physical well-being.
Methods: The hospital-based cross-sectional studies were conducted at the Department of TB and CD for 6 months in a tertiary care hospital. A total of 55 patients diagnosed with COPD participated in the study after signing the informed constant. The individual patients were interviewed using MMAS-8 and Kuppuswamy scale questionnaires. The data were analyzed by Chi-square test to determine the correlation between medication adherence and socioeconomic status in patients with COPD.
Results: Among 55 COPD patients included in the study, their mean age was 62.2(+10.76) years. Out of the total participants: Significant associations between the medication adherence scale (MMRS-8) scores and the Kuppuswamy scale were found as p<0.0001, indicating that medication adherence was influenced by the patient’s socioeconomic status. In addition, the BORG scale which is used to measure exercise tolerance in COPD that found to have a significant correlation with an MMAS-8 score of p=0.03.
Conclusion: Our study found that a person with low socioeconomic levels will have poor adherence to inhaler therapy, leading to poor health outcomes like exacerbation and low physical activity due to shortness of breath.
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References
World Health Organization. Chronic Obstructive Pulmonary Disease (COPD). Geneva: World Health Organization; 2023.
American Lungs Association. COPD Cause and Risk Factor. Chicago: American Lungs Association; 2023.
Verma A, Gudi N, Yadav UN, Roy MP, Mahmood A, Nagaraja R, et al. Prevalence of COPD among population above 30 years in India: A systematic review and meta-analysis. J Glob Health. 2021;11:04038.
Homętowska H, Świątoniowska-Lonc N, Klekowski J, Chabowski M, Jankowska-Polańska B. Treatment adherence in patients with obstructive pulmonary diseases. Int J Environ Res Public Health. 2022 Sep;19(18):11573.
Almadhoun K, Sharma S. Bronchodilators. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2023 Apr 28.
Jimmy B, Jose J. Patient medication adherence: Measures in daily practice. Oman Med J. 2011 May;26(3):155-9. doi: 10.5001/omj.2011.38
Usmani OS. Choosing the right inhaler for your asthma or COPD patient. Ther Clin Risk Manag. 2019;15:461-72. doi: 10.2147/TCRM. S160365, PMID: 30936708
Steinberg M, Helen P. Assessment of proper medication inhaler technique in adult patients. J Pharm Technol. 2014 Oct 13;30(6):195- 200. doi: 10.1177/8755122514553987, PMID: 34860890
Papi A, Qasuri M, Chung E, Abdelbaset M, Aly Moussa M, Backer V, et al. Fixed-dose combination fluticasone/formoterol for asthma treatment in a real-world setting: Meta-analysis of exacerbation rates and asthma control. Eur Clin Respir J. 2023;10(1): 2174642. doi: 10.1080/20018525.2023.2174642, PMID: 36815940
Janežič A, Locatelli I, Kos M. Criterion validity of 8-item morisky medication adherence scale in patients with asthma. PLoS One. 2017;12(11):e0187835. doi: 10.1371/journal.pone.0187835, PMID: 29190693
Wani RT. Socioeconomic status scales-modified Kuppuswamy and Udai Pareekh’s scale updated for 2019. J Family Med Prim Care. 2019 Jun;8(6):1846-9. doi: 10.4103/jfmpc.jfmpc_288_19, PMID: 31334143 12. Jarrah M, Khader Y, Alkouri O, Al-Bashaireh A, Alhalaiqa F, Al Marzouqi A, et al. Medication adherence and its influencing factors among patients with heart failure: A cross sectional study. Medicina. 2023;59(5):960.
Johns DP, Walters JA, Walters EH. Diagnosis and early detection of COPD using spirometry. J Thorac Dis. 2014 Nov;6(11):1557-69. doi: 10.3978/j.issn.2072-1439.2014.08.18, PMID: 25478197
Kvarnström K, Westerholm A, Airaksinen M, Liira H. Factors contributing to medication adherence in patients with a chronic condition: A scoping review of qualitative research. Pharmaceutics. 2021;13(7):1100. doi: 10.3390/pharmaceutics13071100, PMID: 34371791
Mahmood SE, Alqahtani AT, Alghamdi BA, Gazzan MA, Alqahtani M, Alfaifi NA, et al. Awareness of COPD and its risk factors among the adult population of the Aseer Region, Saudi Arabia. Int J Chron Obstruct Pulmon Dis. 2023;18:23-35.
López-Campos JL, Quintana Gallego E, Carrasco Hernández L. Status of and strategies for improving adherence to COPD treatment. Int J Chron Obstruct Pulmon Dis. 2019;14:1503-15.
Exarchos KP, Rovina N, Krommidas G, Latsios D, Gogali A, Kostikas K. Adherence and quality of life assessment in patients with asthma treatment with budesonide/formoterol via the elpenhaler device: The complete study. BMC Pulm Med. 2022;22(1):254. doi: 10.1186/ s12890-022-02049-0, PMID: 35761234
Spencer S, Karner C, Cates CJ, Evans DJ. Inhaled corticosteroids versus long-acting bets2-agonists for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2011 Dec;2011(12):CD007033.
Lewthwaite H, Jensen D, Ekström M. How to assess breathlessness in Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis. 2021;16:1581-98.
Giannitsi S, Bougiakli M, Bechlioulis A, Kotsia A, Michalis LK, Naka KK. 6-minute walking test: A useful tool in the management of heart failure patient. Ther Adv Cardiovasc Dis. 2019;13. doi: 10.1177/1753944719870084, PMID: 31441375
Tabyshova A, Sooronbaev T, Akylbekov A, Mademilov M, Isakova A, Erkinbaeva A, et al. Medication availability and economic barriers to adherence in asthma and COPD patients in low-resource settings. NPJ Prim Care Respir Med. 2011 May 30;32(1):20.
Tøttenborg SS, Lange P, Johnsen SP, Nielsen H, Ingebrigtsen TS, Thomsen RW. Socioeconomic inequalities in adherence to inhaled maintenance medications and clinical prognosis of COPD. Respir Med. 2016 Oct;119:160-7.
Pottegård A, Christensen RD, Houji A, Christiansen CB, Paulsen MS, Thomsen JL, et al. Primary non-adherence in general practice: A Danish register study. Eur J Clin Pharmacol. 2014 Apr 23;70(6):757-63.
Moradkhani B, Mollazadeh S, Niloofar P, Bashiri A, Oghazian MB. Association between medication adherence and health-related quality of life in patients with chronic obstructive pulmonary disease. J Pharm Health Care Sci. 2021 Nov 15;7(1):40.
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