Cross-sectional analysis of factors associated with medication adherence in western Kenya

被引：6

作者：

Gala, Pooja ^{[1
]}

Kamano, Jemima H. ^{[2
]}

Vazquez Sanchez, Manuel ^{[3
]}

Mugo, Richard ^{[4
]}

Orango, Vitalis ^{[2
,4
]}

Pastakia, Sonak ^{[5
]}

Horowitz, Carol ^{[6
]}

Hogan, Joseph W. ^{[7
]}

Vedanthan, Rajesh ^{[8
]}

机构：

[1] NYU, Grossman Sch Med, Med, New York, NY 10016 USA

[2] Moi Univ, Med, Eldoret, Kenya

[3] NYU, Grossman Sch Med, Populat Hlth, New York, NY USA

[4] Acad Model Providing Access Healthcare AMPATH, Eldoret, Kenya

[5] Purdue Univ, Coll Pharm Nursing & Hlth Sci, Ctr Hlth Equ & Innovat, W Lafayette, IN 47907 USA

[6] Icahn Sch Med Mt Sinai, Med & Populat Hlth Sci, New York, NY 10029 USA

[7] Brown Univ, Biostat, Providence, RI 02912 USA

[8] NYU, Grossman Sch Med, Med & Populat Hlth, New York, NY USA

来源：

BMJ OPEN | 2023年 / 13卷 / 09期

基金：

美国国家卫生研究院;

关键词：

PUBLIC HEALTH; Hypertension; EPIDEMIOLOGY; CLINICAL PHARMACOLOGY; MIDDLE-INCOME COUNTRIES; ANTIHYPERTENSIVE MEDICATION; BLOOD-PRESSURE; CARE; NONADHERENCE; HYPERTENSION; DISEASE;

D O I：

10.1136/bmjopen-2023-072358

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives Poor medication adherence in low-income and middle-income countries is a major cause of suboptimal hypertension and diabetes control. We aimed to identify key factors associated with medication adherence in western Kenya, with a focus on cost-related and economic wealth factors. Setting We conducted a cross-sectional analysis of baseline data of participants enrolled in the Bridging Income Generation with Group Integrated Care study in western Kenya. Participants All participants were >= 35 years old with either diabetes or hypertension who had been prescribed medications in the past 3months. Primary and secondary outcome measures Baseline data included sociodemographic characteristics, wealth and economic status and medication adherence information. Predictors of medication adherence were separated into the five WHO dimensions of medication adherence: condition-related factors (comorbidities), patient-related factors (psychological factors, alcohol use), therapy-related factors (number of prescription medications), economic-related factors (monthly income, cost of transportation, monthly cost of medications) and health system-related factors (health insurance, time to travel to the health facility). A multivariable analysis, controlling for age and sex, was conducted to determine drivers of suboptimal medication adherence in each overarching category. Results The analysis included 1496 participants (73.7%women) with a mean age of 60 years (range 35-97). The majority of participants had hypertension (69.2%), 8.8% had diabetes and 22.1% had both hypertension and diabetes. Suboptimal medication adherence was reported by 71.2% of participants. Economic factors were associated with medication adherence. In multivariable analysis that investigated specific subtypes of costs, transportation costs were found to be associated with worse medication adherence. In contrast, we found no evidence of association between monthly medication costs and medication adherence. Conclusion Suboptimal medication adherence is highly prevalent in Kenya, and primary-associated factors include costs, particularly indirect costs of transportation. Addressing all economic factors associated with medication adherence will be important to improve outcomes for non-communicable diseases.

引用

页数：9

共 56 条

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