Assessment of medication adherence in individuals with chronic diseases

Objective: Chronic disease is defined as long-term conditions which occur due to a combination of many causes, cannot be treated, and require regular treatment, care and lifestyle changes. Chronic diseases require long-term drug use in terms of reducing morbidity and mortality. Medication adherence refers to all the decisions about prescribing the patient's drugs, starting, continuing and discontinuing them, and applying the recommendations received in this process. This may be a process that complicates the individual's daily life activities. Therefore, the aim of this study is to assess the medication adherence in individuals with chronic diseases. Method: This is a descriptive and cross-sectional study. The population of the study consisted of patients receiving treatment at Al-Nasiriyah Teaching Hospital in Dhi-Qar City, Iraq. Data were collected between December 2021 and May 2022. 208 patients were included in the study. Data were collected through face-to-face interview method using a socio-demographic questionnaire and General Medication Adherence Scale (GMAS). SPSS Statistics (Statistical Package for Social Sciences) for Windows 25.0 software was used to assess the data. Percentage, total score calculation, t-test and ANOVA were used. Results: The study findings revealed that 73.6% of the participants were over the age of 46, 57.2% were female, 74.5% were married, 27.4% were illiterate, 54.8% were unemployed, 78.8% were living in the city, 66.3% had an additional chronic disease, and the most common additional chronic disease was hypertension with a rate of 32.2%. The scores of the scale's subscales were found to be 10.15±4.57 for Patient Behavior related Non-Adherence, 8.79±2.73 for additional disease and pill burden, 4.13±1.79 for cost-related non-adherence, and total scale score was 23.07±7.70, respectively. The cost-related non-adherence subscale scores of those under the age of 45 were lower. Scores of additional disease and pill burden subscale and cost-related non-adherence subscale and total scores of GMAS were lower and statistically significant in married ones compared to the others, in illiterate ones than their literate counterparts, in employed ones than their unemployed counterparts (p<0.05). All subscale and total scores of those living in rural areas were lower than the scores of those living in urban areas, and the additional disease and pill burden and GMAS total mean score were lower and statistically significant in those who had additional chronic diseases compared to those who did not(p<0.05). Conclusion: Nurses should regularly organize education programs at certain time intervals for patients who use drugs regularly and should raise their awareness about use of their drugs. Nurses should especially arrange the treatment plan of elderly individuals in a way to prevent the negative effects that may occur as a result of the use of multiple medications.