Adherence to COPD treatment in Turkey and Saudi Arabia: results of the ADCARE study

Nurdan Kokturk, Mehmet Polatli, I Kivilcim Oguzulgen, Sarfraz Saleemi, Mohammed Al Ghobain, Javed Khan, Adam Doble, Luqman Tariq, Fayaz Aziz, Abdelkader El Hasnaoui

Overview

ABSTRACT: Background: COPD affects millions of people worldwide. Poor treatment adherence contributes to increased symptom severity, morbidity and mortality. This study was designed to investigate adherence to COPD treatment in Turkey and Saudi Arabia. Methods: An observational, cross-sectional study in adult COPD patients in Turkey and Saudi Arabia. Through physician-led interviews, data were collected on sociodemographics and disease history, including the impact of COPD on health status using the COPD Assessment Test (CAT); quality of life, using the EuroQol Five-Dimension questionnaire (EQ-5D); and anxiety and depression using the Hospital Anxiety and Depression Scale (HADS). Treatment adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS-8). Multivariate logistic regression analysis examined the predictors of non-adherence and the impact of adherence on symptom severity. Results: Four hundred and five COPD patients participated: 199 in Turkey and 206 in Saudi Arabia. Overall, 49.2% reported low adherence (MMAS-8 <6). Of those, 74.7% reported high disease impact (CAT >15) compared to 58.4% reporting medium/high adherence (p=0.0008). Patients with low adherence reported a lower mean 3-level EQ-5D utility value (0.54±0.35) compared to those with medium/high adherence (0.64±0.30; p<0.0001). Depression with HADS score 8–10 or >10 was associated with lower adherence (OR 2.50 [95% CI: 1.43–4.39] and 2.43 [95% CI: 1.39–4.25], respectively; p=0.0008). Being a high school/college graduate was associated with better adherence compared with no high school (OR 0.57 [95% CI: 0.33–0.98] and 0.38 [95% CI: 0.15–1.00], respectively; p=0.0310). After adjusting for age, gender, and country, a significant association between treatment adherence (MMAS-8 score ?6) and lower disease impact (CAT ?15) was observed (OR 0.56 [95% CI: 0.33–0.95]; p=0.0314). Conclusion: Adherence to COPD treatment is poor in Turkey and Saudi Arabia. Non-adherence to treatment is associated with higher disease impact and reduced quality of life. Depression, age, and level of education were independent determinants of adherence.

Summary

A first hand data on adherence to treatment in COPD in this region

Altmetric Statistics

Author Comments

Sarfraz Saleemi, MD,MRCP,FCCP
Sarfraz Saleemi, MD,MRCP,FCCP
King Faisal Specialist Hospital and Research Centre
Dr
Pulmonary Hypertension
Riyadh, Riyadh | Saudi Arabia
The study highlights the fact that adherence to treatment factor in the management of COPD should be looked at when managing these patients.Sarfraz Saleemi, MD,MRCP,FCCP

Resources

ORCID
https://orcid.org/0000-0002-6996-6490

Adherence to COPD treatment in Turkey and Saudi Arabia: results of the ADCARE study.

Authors:
Sarfraz Saleemi, MD,MRCP,FCCP
Sarfraz Saleemi, MD,MRCP,FCCP
King Faisal Specialist Hospital and Research Centre
Dr
Pulmonary Hypertension
Riyadh, Riyadh | Saudi Arabia

Int J Chron Obstruct Pulmon Dis 2018;13:1377-1388. Epub 2018 Apr 27.

GlaxoSmithKline, Dubai, UAE.

Background: COPD affects millions of people worldwide. Poor treatment adherence contributes to increased symptom severity, morbidity and mortality. This study was designed to investigate adherence to COPD treatment in Turkey and Saudi Arabia.

Methods: An observational, cross-sectional study in adult COPD patients in Turkey and Saudi Arabia. Through physician-led interviews, data were collected on sociodemographics and disease history, including the impact of COPD on health status using the COPD Assessment Test (CAT); quality of life, using the EuroQol Five-Dimension questionnaire (EQ-5D); and anxiety and depression using the Hospital Anxiety and Depression Scale (HADS). Treatment adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS-8). Multivariate logistic regression analysis examined the predictors of non-adherence and the impact of adherence on symptom severity.

Results: Four hundred and five COPD patients participated: 199 in Turkey and 206 in Saudi Arabia. Overall, 49.2% reported low adherence (MMAS-8 <6). Of those, 74.7% reported high disease impact (CAT >15) compared to 58.4% reporting medium/high adherence (=0.0008). Patients with low adherence reported a lower mean 3-level EQ-5D utility value (0.54±0.35) compared to those with medium/high adherence (0.64±0.30; <0.0001). Depression with HADS score 8-10 or >10 was associated with lower adherence (OR 2.50 [95% CI: 1.43-4.39] and 2.43 [95% CI: 1.39-4.25], respectively; =0.0008). Being a high school/college graduate was associated with better adherence compared with no high school (OR 0.57 [95% CI: 0.33-0.98] and 0.38 [95% CI: 0.15-1.00], respectively; =0.0310). After adjusting for age, gender, and country, a significant association between treatment adherence (MMAS-8 score ≥6) and lower disease impact (CAT ≤15) was observed (OR 0.56 [95% CI: 0.33-0.95]; =0.0314).

Conclusion: Adherence to COPD treatment is poor in Turkey and Saudi Arabia. Non-adherence to treatment is associated with higher disease impact and reduced quality of life. Depression, age, and level of education were independent determinants of adherence.

Download full-text PDF

Source
https://www.dovepress.com/adherence-to-copd-treatment-in-tur
Publisher Site
http://dx.doi.org/10.2147/COPD.S150411DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5927343PMC
October 2018
11 Reads
2.732 Impact Factor

Publication Analysis

Top Keywords

saudi arabia
16
turkey saudi
16
adherence
15
treatment adherence
12
adherence copd
12
copd treatment
12
low adherence
8
disease impact
8
medium/high adherence
8
quality life
8
copd patients
8
adherence mmas-8
8
anxiety depression
8
treatment turkey
8
copd
7
treatment
7
[95%
5
saudi
5
turkey
5
lower 3-level
4

Similar Publications