Necessity and concerns about lipid-lowering medical treatments and risk factors for non-adherence: A cross-sectional study in Palestine.

AIMS: Strong evidence indicates that drugs reduce blood lipids and improve cardiovascular end-points, leading to their wide usage. However, the success of these drugs can be affected by poor patient's adherence to prescribed medication. This study aimed to evaluate medication adherence in patients with dyslipidaemia in association with patient beliefs about medicines. METHODS: The study was conducted from January 2019 to July 2019 at the middle governmental primary healthcare clinics in Ramallah and Bethlehem cities, and used a cross-sectional design. Adherence was determined using the 4-item Morisky medication adherence scale, while beliefs were determined using the Beliefs about Medicines Questionnaire. RESULTS: Of 220 patients, 185 agreed to participate in the study, resulting in a response rate of 84.1%. Of the participants, 106 (57.3%) were men, and almost half (88, 46.5%) were ≥56 years. Medication non-adherence was high (47.6%), but a majority (65.5%) reported believing their treatment to be necessary for their continued good health. Accordingly, the mean necessity score (17.3, SD 3.7) significantly outweighed (P < .001) the mean concerns score (14.0, SD 3.5). Multivariate regression demonstrated four variables to be significantly correlated with non-adherence: illiterate (OR = 2.52; CI: 0.9-4.3; P = .03), polypharmacy (OR = 3.18; CI: 1.9-5.7; P = .007), having comorbidity (OR = 3.10; CI: 2.2-4.6; P = .005) and having concerns about side effects (OR = 2.89; CI: 1.1-4.6, P = .04). CONCLUSION: Non-adherence among patients taking lipid-lowering agents was high despite most holding positive beliefs regarding medication necessity. This may be due to concern also being high. Physicians should identify and target high-risk patients and individualise their treatment plans in order to achieve adequate control of dyslipidaemia.

Assessment of treatment satisfaction and adherence amongst diabetic patients in governmental primary care clinic of Ramallah, West-Bank.

OBJECTIVE: This study aimed to assess treatment satisfaction and its association with medication adherence among patients with diabetes. METHODS: Participants in this study were outpatients at the governmental Primary Healthcare Unit in Ramallah. Adherence was measured with the 4-item Morisky Green-Levine (MGL) questionnaire, and treatment satisfaction with the Treatment Satisfaction Questionnaire for Medication version 1.4. Glycemic control was measured as the last value of an HbA1c test, with HbA1c ≤7 considered good. RESULTS: Of the participants, 220 (57.9%) were classified as having high adherence to their medications, and 160 (42.1%) as having low adherence. Regarding glycemic control, 174 (45.7%) of patients had good control, while 206 (54.2%) had poor control. Satisfaction with treatment effectiveness showed a significant mean difference with adherence level (78.61 vs. 74.2; p = 0.04). Glycemic controlled patients had a higher and significant adherence mean in the global satisfaction domain (69.19 vs. 62.08; p = 0.01). However, glycemic control level had no significant differences in means of effectiveness, side effects, and convenience domains (P = 0.31, 0.49, 0.37) respectively. CONCLUSIONS: Treatment satisfaction level is lower among low adherence and poor glycemic control. Addressing the specific needs of these patients might be effective in improving their satisfaction, thus having a positive influence on other clinical outcomes.

Treatment Satisfaction and Quality of Life among Type 2 Diabetes Patients: A Cross-Sectional Study in West Bank, Palestine.

OBJECTIVES: This study had the goal of evaluating the role of treatment satisfaction among diabetic patients in the context of health-related quality of life (QoL) and medication adherence. METHODS: This study, which utilized a cross-sectional design, was conducted at the Primary Healthcare Unit in the Ministry of Health in Ramallah between Feb. and May 2019. Medication adherence was evaluated with the 4-item Morisky Green-Levine (MGL) questionnaire, treatment satisfaction using the Treatment Satisfaction Questionnaire for Medication version 1.4 (TSQM 1.4), and health-related quality of life with the European Quality of Life scale (EQ-5D-3L). RESULTS: Study participants consisted of 380 diabetic patients, of which 220 (57.9%) had high adherence to their medications and 160 (42.1%) had low adherence. Based on the classification of patient responses among the EQ-5D domains, pain/discomfort was the most influenced dimension, with 173 patients (36.1%) reporting problems, (36.1%). Also prominent were anxiety and depression (128 patients, 33.7%) and Mobility (115 patients, 30.3%). A significant relation was observed between QoL and treatment satisfaction (73.8 vs. 69.8; P = 0.016). Treatment satisfaction also had a significant association with the anxiety domain (39.4 vs. 28.7; P = 0.031). CONCLUSION: Participants expressed moderate satisfaction with their treatments; more satisfied patients showed greater medication adherence and had better QoL. Anxiety has been shown to be associated with reduced medication adherence and lower QoL.