Factors Associated with Adherence to Medication among Chronic Obstructive Pulmonary Disease Patients in Tertiary Care Hospital of Nepal: A Cross-Sectional Study

Objective: Patients with chronic obstructive pulmonary disease (COPD) are known to have poor medication adherence in Nepal. Various factors affect the medication adherence of COPD patients. Therefore, we aimed to evaluate the medication adherence and its associated factors among the COPD patients in tertiary care hospitals in central Nepal.

Methods: A hospital-based cross-sectional study was carried out among 164 patients aged ≥18 years, diagnosed with and under medication(s) of COPD for at least 6 months from September 2017 to March 2018, in a tertiary care hospital in central Nepal, using a purposive sampling technique. Morisky Green Levine Adherence (MGLA) score was employed to determine the rate of medication adherence. The differences between the two groups (adherent and non-adherent) were tested using independent t-test, and Chi-square tests, p<0.05 was considered statistically significant.

Results: Patients were mostly ≥60 years (87.1%) and female (56.7%). The majority of the patients were found adherent to the prescribed treatment (108; 65.9%). The major reason for non-adherence was seem to be stopping medicine when feeling better (41.08%) and most of the patients had discontinued the medication due to experience of symptomatic relief (42.9%).Medication adherence was statistically significant with age group at p=0.040, educational status p=0.020, no. of daily drugs p= 0.029, and health behavior of the patients (p= 0.025).

Conclusion: Our study suggested that two-third of COPD patients were adherent to their medication, and age, education, number of drugs, and health behaviors of the patients were the most influencing factors for medication adherence.