|
|
|
| Influencing factors for medication compliance in patients with comorbidities of chronic diseases: a meta-analysis |
| LIU Yudan1, ZHANG Caiyun1,2, GUO Mingmei2, ZHENG Yujuan2, JIA Ming1, YANG Jiale1, HOU Jianing1, ZHAO Hua1
|
1. School of Nursing, Shanxi University of Chinese Medicine, Jinzhong, Shanxi 030619, China;
2. Shanxi Provincial People's Hospital, Taiyuan, Shanxi 030012, China |
|
|
|
|
Abstract Objective To systematically evaluate the influencing factors for medication compliance in patients with comorbidities of chronic diseases, so as to provide the evidence for improving medication compliance. Methods Literature on influencing factors for medication compliance in patients with comorbidities of chronic diseases were retrived from CNKI, Wanfang Data, VIP, SinoMed, PubMed, Web of Science, Cochrane Library and Embase from inception to January 20, 2024. After independent literature screening, data extraction, and quality assessment by two researchers, a meta-analysis was performed using RevMan 5.4 and Stata 16.0 softwares. Literature were excluded one by one for sensitivity analysis. Publication bias was assessed using Egger's test. Results Initially, 7 365 relevant articles were retrieved, and 35 of them were finally included, with a total sample size of about 150 000 individuals. There were 30 cross-sectional studies and 5 cohort studies; and 11 high-quality studies and 24 medium-quality studies. The meta-analysis showed that the demographic factors of lower level of education (OR=2.148, 95%CI: 1.711-2.696), lower economic income (OR=1.897, 95%CI: 1.589-2.264), male (OR=0.877, 95%CI: 0.782-0.985), living alone (OR=2.833, 95%CI: 1.756-4.569) and unmarried (OR=2.784, 95%CI: 1.251-6.196); the medication treatment factors of polypharmacy (OR=1.794, 95%CI: 1.190-2.706), potentially inappropriate medication (OR=2.988, 95%CI: 1.527-5.847), low frequency of daily medication (OR=0.533, 95%CI: 0.376-0.754) and adverse drug reactions (OR=3.319, 95%CI: 1.967-5.602); the disease factors of long course of disease (OR=2.118, 95%CI: 1.643-2.730), more comorbidities (OR=1.667, 95%CI: 1.143-2.431) and cognitive impairment (OR=2.007, 95%CI: 1.401-2.874); and the psychosocial factors of poor belief in taking medication (OR=1.251, 95%CI: 1.011-1.547), poor self-rated health (OR=1.990, 95%CI: 1.571-2.522) and being guided by healthcare professionals (OR=0.151, 95%CI: 0.062-0.368) were the influencing factors for medication compliance in patients with chronic comorbidities. Conclusion The medication compliance in patients with comorbidities of chronic diseases is associated with demographic factors, pharmacological factors, disease factors and psychosocial factors, mainly including living alone, adverse drug reactions, course of disease, number of comorbidities and medication beliefs.
|
|
Received: 28 March 2024
Revised: 14 May 2024
Published: 18 September 2024
|
|
|
|
|
|
[1] GENG Y,JIE W,HE Y,et al.Prevalence and patterns of multimorbidity among adults aged 18 years and older-China,2018[J].China CDC Wkly,2023,5(2):35-39.
[2] FÉLIX I B,HENRIQUES A.Medication adherence and related determinants in older people with multimorbidity:a cross-sectional study[J].Nurs Forum,2021,56(4):834-843.
[3] WANG W N,LUAN W Y,ZHANG Z X,et al.Association between medication literacy and medication adherence and the mediating effect of self-efficacy in older people with multimorbidity[J].BMC Geriatr,2023,23(1):378-386.
[4] LIU J M,YU Y P,YAN S Y,et al.Risk factors for self-reported medication adherence in community-dwelling older patients with multimorbidity and polypharmacy:a multicenter cross-sectional study[J].BMC Geriatr,2023,23(1):75-84.
[5] 曾宪涛,刘慧,陈曦,等.Meta分析系列之四:观察性研究的质量评价工具[J].中国循证心血管医学杂志,2012,4(4):297-299.
[6] STANG A.Critical evaluation of the Newcastle-Ottawa Scale for the assessment of the quality of nonrandomized studies in meta-analyses[J].Eur J Epidemiol,2010,25(9):603-605.
[7] 王金明,林盛强,杨玉明,等.社区共病患者服药依从性及影响因素调查分析[J].中国全科医学,2017,20(23):2827-2831.
[8] 姚媛英. 社区老年共病患者服药依从性及影响因素研究[D].开封:河南大学,2018.
[9] 谢晓华,苏正丽,刘咏梅.2型糖尿病合并高脂血症患者调脂药物服药依从性现状及影响因素分析[J].临床误诊误治,2019,32(11):35-38.
[10] 张鑫,兰晶.冠心病合并高血压患者二级预防服药依从性及影响因素[J].中国卫生工程学,2019,18(4):559-561.
[11] 周永林. 门诊糖尿病合并高血压患者降压药物使用依从性及影响因素[J].中外医学研究,2019,17(35):70-72.
[12] 陈超. 吉林市社区老年慢性病共病患者居家用药依从性与用药安全现状研究[D].长春:长春中医药大学,2021.
[13] 梁晓娜. 老年慢性心衰并房颤患者药物依从性及预后的影响因素分析[D].石河子:石河子大学,2021.
[14] 罗燕,段棣飞,马登艳,等.慢性肾脏病合并高血压患者的高血压治疗依从性调查分析[J].广西医学,2021,43(8):1027-1031,1038.
[15] 戴素贞. 维持性血液透析合并高血压患者降压药服药依从性及影响因素分析[J].心血管病防治知识,2021,11(32):51-53.
[16] 冯进,杨家慧,曹世琦,等.维持性血液透析合并高血压患者降压药服药依从性及影响因素分析[J].华南预防医学,2021,47(7):875-877,881.
[17] 胡志成,刘尚雨,沈利水,等.伴心房颤动的老年高血压患者降压药服药依从性不良影响因素分析[J].中国心血管病研究,2021,19(2):102-106.
[18] 王志羽. 老年共病患者疾病接受度和服药依从性与多重用药负担的关系[D].唐山:华北理工大学,2022.
[19] 张振香,何福培,张春慧,等.慢性病共病患者服药依从性潜在类别及其影响因素分析[J].中国全科医学,2022,25(31):3904-3913.
[20] 王冠,徐兴祥.稳定期COPD合并肺癌患者吸入药物使用依从性现状及影响因素分析[J].临床肺科杂志,2022,27(11):1706-1710.
[21] 王剑,马陈芳,丁嘉寅,等.老年高血压合并糖尿病患者服药依从性的影响因素[J].中华高血压杂志,2022,30(11):1085-1089.
[22] 王秋玲,李海燕,陆清声.主动脉瘤合并高血压患者服用降血压药物的依从性及影响因素[J].血管与腔内血管外科杂志,2023,9(3):275-280.
[23] MARCUM Z A,ZHENG Y,PERERA S,et al.Prevalence and correlates of self-reported medication non-adherence among older adults with coronary heart disease,diabetes mellitus,and/or hypertension[J].Res Social Adm Pharm,2013,9(6):817-827.
[24] NAIDOO P,PELTZER K,LOUW J,et al.Predictors of tuberculosis(TB)and antiretroviral(ARV)medication non-adherence in public primary care patients in South Africa:a cross sectional study[J].BMC Public Health,2013,13:396-405.
[25] CICOLINI G,COMPARCINI D,FLACCO M E,et al.Self-reported medication adherence and beliefs among elderly in multi-treatment:a cross-sectional study[J].Appl Nurs Res,2016,30:131-136.
[26] LI Y T,WANG H H X,LIU K Q L,et al.Medication adherence and blood pressure control among hypertensive patients with coexisting long-term conditions in primary care settings:a cross-sectional analysis[J/OL].Medicine(Baltimore),2016,95(20)[2024-05-14].https://doi.org/10.1097/MD.0000000000003572.
[27] CALIP G S,ELMORE J G,BOUDREAU D M.Characteristics associated with nonadherence to medications for hypertension,diabetes,and dyslipidemia among breast cancer survivors[J].Breast Cancer Res Treat,2017,161(1):161-172.
[28] LUNGHI C,ZONGO A,MOISAN J,et al.Factors associated with antidiabetic medication non-adherence in patients with incident comorbid depression[J].J Diabetes Complications,2017,31(7):1200-1206.
[29] FERNANDEZ-LAZARO C I,ADAMS D P,FERNANDEZ-LAZARO D,et al.Medication adherence and barriers among low-income,uninsured patients with multiple chronic conditions[J].Res Social Adm Pharm,2019,15(6):744-753.
[30] WALSH C A,BENNETT K E,WALLACE E,et al.Identifying adherence patterns across multiple medications and their association with health outcomes in older community-dwelling adults with multimorbidity[J].Value Health,2020,23(8):1063-1071.
[31] MIYAZAKI M,UCHIYAMA M,NAKAMURA Y,et al.Association of self-reported medication adherence with potentially inappropriate medications in elderly patients:a cross-sectional pilot study[J/OL].Int J Environ Res Public Health,2020,17(16)[2024-05-14].https://doi.org/10.3390/ijerph17165940.
[32] GONZALEZ-BUENO J,SEVILLA-SÁNCHEZ D,PUIGORIOL-JUVANTENY E,et al.Factors associated with medication non-adherence among patients with multimorbidity and polypharmacy admitted to an intermediate care center[J/OL].Int J Environ Res Public Health,2021,18(18)[2024-05-14].https://doi.org/10.3390/ijerph18189606.
[33] SHIMELS T,KASSU R A,BOGALE G,et al.Magnitude and associated factors of poor medication adherence among diabetic and hypertensive patients visiting public health facilities in Ethiopia during the COVID-19 pandemic[J/OL].PLoS One.2021,16(4)[2024-05-14].https://doi.org/10.1371/journal.pone.0249222.
[34] ALLAHAM K K,FEYASA M B,GOVENDER R D,et al.Medication adherence among patients with multimorbidity in the United Arab Emirates[J].Patient Prefer Adherence,2022,16:1187-1200.
[35] FRANCHI C,LUDERGNANI M,MERLINO L,et al.Multiple medication adherence and related outcomes in community-dwelling older people on chronic polypharmacy:a retrospective cohort study on administrative claims data[J].Int J Environ Res Public Health,2022,19(9):5692-5703.
[36] BRIMAVANDI M,ABBASI P,KHALEDI-PAVEH B,et al.Examining the relationship between depression and medication adherence among elderlies suffering from cardiovascular disease referring to the clinics affiliated with Kermanshah University of Medical Sciences:a cross-sectional study[J/OL].Health Sci Rep,2023,6(8)[2024-05-14].https://doi.org/10.1002/hsr2.1503.
[37] FOLEY L,DOHERTY A S,WALLACE E,et al.Exploring the multidimensional relationship between medication beliefs and adherence to medications among older adults living with multimorbidity using polynomial regression:an observational cohort study[J].Ann Behav Med,2023,57(7):561-570.
[38] AL-AZAYZIH A,KANAAN R J,ALTAWALBEH S M,et al.Medication adherence and its associated determinants in older adults with type 2 diabetes and cardiovascular comorbidities[J].Patient Prefer Adherence,2023,17:3107-3118.
[39] 罗发燕,陈铁霞,罗平平,等.慢性乙型肝炎患者服药依从性调查[J].预防医学,2023,35(11):966-969,974.
[40] DEMIRTURK E,ASILAR R H.The effect of depression on adherence to antihypertensive medications in elderly individuals with hypertension[J].J Vasc Nurs,2018,36(3):129-139. |
|
|
|
