The level of drug compliance and loneliness in adult patients with multiple drug use outpatient to the family medicine polyclinics at Van Yüzüncü Yil University Faculty of Medicine

Aim: Polypharmacy refers to the simultaneous use of multiple drugs. Increasing polypharmacy worldwide is associated with adverse conditions such as decreased drug compliance, drug-drug interactions, drug side effects, and increased health costs. According to the World Health Organization, compliance is defined as the degree to which individuals' behavior (including drug intake) corresponds to the recommendations of the healthcare provider. Drug nonadherence is a condition associated with an increase in health costs as well as conditions such as increased mortality and morbidity. Loneliness, on the other hand, corresponds to the discrepancy between an individual's choice and their real social relationships. Loneliness is associated with an increased risk of mortality, some health-negative behaviors and some unwanted laboratory values. In this study; sociodemographic characteristics, drug compliance, loneliness and the relationship of these variables in adult patients using multiple drugs were investigated. It was aimed to determine the properties that adversely affect drug compliance and to offer solutions against them. Matherials and Methods: This study is a cross-sectional descriptive survey study conducted between May 2019 and August 2019, which included adult individuals who applied to the Family Medicine Polyclinics in Van Yüzüncü Yıl University Faculty of Medicine in Van. This study included 220 patients over the age of 18 who had been using at least two different medications for at least 240 days. The patients were first asked questions in the sociodemographic information form, which also included some questions regarding polypharmacy and drug compliance. Later, the patients were administered the Modified Morisky Scale and the UCLA (University of California Los Angeles) Loneliness Scale. The questionnaire was applied by the researcher with the face-to-face interview technique after obtaining the consent of the patients. Descriptive statistics for continuous variables are expressed as mean, standard deviation, minimum and maximum values. Descriptive statistics are expressed as numbers and percentages for categorical variables. One-way analysis of variance was made to compare group means in terms of continuous variables. Duncan Multiple Comparison Test was used to identify different groups following analysis of variance. In determining the relationship between these variables, Pearson Correlation Coefficients were calculated separately in the groups. In determining the relationship between groups and categorical variables, chi-square test was performed. Statistical significance level was taken as 5% in calculations and Statistical Package For Social Sciences (SPSS) statistical package program was used for calculations. Results: Of the 220 patients participating in the study, 55% were female and 45% were male. The average age was 58.57 ± 12.04. 63% of the patients participating in the study had hypertension, 48.3% had diabetes mellitus and 34% had atherosclerotic heart disease. It was determined that 68.6% of the participants did not regularly apply to family physicians for their chronic illnesses. The proportion of patients using minor polypharmacy was 56.4%, while those using major polypharmacy were 43.6%. The proportion of women using minor polypharmacy was significantly higher than men using minor polypharmacy. The level of knowledge, motivation and loneliness of the participants did not differ according to the use of minor or major polypharmacy. While the rate of antihypertensive drug use was 70%, the rate of antidiabetic drug use was 47.2% and the rate of anticoagulant/antiaggregant drug use was 35%. The proportion of patients with no knowledge of drug side effects was 58.6%. In terms of drug compliance, 70% of the participants were motivated and 75.9% of them had a high level of knowledge. The level of knowledge of the participants was significantly higher in male gender. It was determined that 63.7% of the participants felt loneliness at various levels. The level of loneliness was significantly higher in female gender. The motivation, knowledge and loneliness levels of the participants did not differ according to age. The loneliness level of the participants was significantly higher in the non-employed than the employees and retirees. The motivation level of the participants was significantly higher in the group which was always informed by the physician than those who were never informed. Both the motivation and knowledge levels of the participants who stated that they used their medicines regularly were significantly higher than those who stated that they sometimes disrupted their medications. There was no significant relationship between participants' loneliness and motivation/knowledge levels. Conclusion: Reviewing the medications used by patients with chronic diseases -especially those using polypharmacy and in the elderly group- by regular checkups and giving information about the medications they use; may be useful to prevent inappropriate polypharmacy use and to improve drug compliance. Since the loneliness levels of women and/or non-working patients with polypharmacy use may be higher, conducting mental health examinations of these patients and directing patients to various sociocultural activities when necessary may help to decrease their loneliness levels.