Risk factors and quality of life of dyslipidemic patients in Lebanon: A cross-sectional study.

The main objective of this study was to identify the risk factors of dyslipidemia and measure its impact on patients' quality of life (QOL). Secondary objectives were to determine the percentage of dyslipidemia and assess the predictive factors affecting patients' QOL. A cross-sectional study was conducted in a sample of Lebanese population. A standardized questionnaire was developed to assess the QOL using the Short form-36 (SF-36) score. A total of 452 individuals were interviewed, of which 59.5% were females. The mean age was 43.3±15.6years, and 24.8% had dyslipidemia. The results show a lower overall QOL score among dyslipidemic patients compared with controls (57.9% and 76.5%, respectively; p<0.001). Waterpipe smoking [adjusted odds ratio (ORa)=4.113, 95% confidence interval (CI): 1.696-9.971, p=0.002], hypertension (ORa=3.597, 95% CI: 1.818-7.116, p<0.001), diabetes (ORa=3.441, 95% CI: 1.587-7.462, p=0.002), cigarette smoking (ORa=2.966, 95% CI: 1.516-5.804, p=0.001), and passive smoking (ORa=2.716, 95% CI: 1.376-5.358, p=0.004) were significantly associated with dyslipidemia in individuals older than 30years. A higher overall QOL score (p=0.013) was observed in patients treated with statins in comparison with other lipid-lowering medications. In addition to clinical and economical consequences, dyslipidemia may have a significant impact on patients' QOL. Further research is needed to confirm the impact of treatment on dyslipidemic patients' QOL in order to maximize the overall benefits of therapy.

Factors affecting medication adherence in Lebanese patients with chronic diseases.

BACKGROUND: Non-adherence to prescribed medications represents an obstacle toward achieving treatment goals. This problem is more pronounced in patients with chronic illness. OBJECTIVE: To identify the extent of adherence in Lebanese outpatients with chronic diseases, and to suggest possible predictors of non-adherence in this population. The secondary objective was to assess if medication adherence affects patients' quality of life. METHODS: A questionnaire was administered face-to-face to a sample of Lebanese adults visiting the external clinics at two Tertiary Care Hospitals in Beirut. The level of adherence was assessed using the 8-item Morisky Medication Adherence Scale which was first validated. The health-related quality of life (HRQoL) of patients was measured using the EQ-5D. Linear regression and logistic regression analyses examined possible predictors of adherence. RESULTS: Out of the 148 patients included in this study, 42.6% were classified as adherent. In the univariate analyses, statistically significant predictors of high adherence included good physician-patient relationship (p=0.029) and counseling (p=0.037), a high level of HRQoL (p<0.001), and a high level of perceived health (p<0.001). Predictors of low adherence included a declining memory (p<0.001), anxiety/depression (p=0.002), little drug knowledge (p<0.001), and postponing physician appointments (p<0.001). The multivariate analyses revealed similar results. In the linear regression, the most powerful predictor of non-adherence was the disbelief that the drug is ameliorating the disease (beta=0.279), however, in logistic regression, patient who were willing to skip or double doses in case of amelioration/deterioration were found to be 7.35 times more likely to be non-adherent than those who were not (aOR=0.136, 95% CI: 0.037-0.503). CONCLUSION: The findings of this study reassure the view that patients should be regarded as active decision makers. Patient education should be regarded as a cornerstone for treatment success. Additional studies as well are needed to test the practicability and effectiveness of interventions suggested to enhance adherence.