Some specifics of adherence to chronic drug therapy in patients with hypertension, tuberculosis and HIV/AIDS in the Republic of Macedonia

Abstract

Adherence to treatment is a key link between process and outcome during treatment. Inadequate adherence to the treatment regimen can have a profound impact on the clinical outcome of the disease / condition. Typically, the adherence to prescribed drugs is approximately 50% and varies between 0% and 100%. Adherence to chronic drug therapy is a multidimensional phenomenon determined by the mutual impacting factors. With this research we have attempted to examine the adherence to chronic medication/drug treatment among patients with TB, hypertension and HIV/ AIDS and possible interlinks between their employment status, health insurance status and a cost of medicines or cost of transportation to collect medicines. Material and methods: We have conducted across-sectional study with commencing self-reporting unstandardized (for socio-economic info) questionnaire and standardized Morisky, Green, and Levine Adherence Scale (MGL). From more than  5000 questionnaires distributed, we have collected 3464 completed questionnaires which providedthe basis for statistical analysis. Results: The results inpatients with hypertension and HIV/AIDS indicated positive correlation between unemploymentand adherence with a decreased adherence to prescribed therapy. In addition, inpatients with hypertension who were without health insurance, adherence to prescribed medication/drug treatment was reduced.The results obtained indicated that the price of the drug has a role in adherence in patients with hypertension, with links of decreased adherence correlating with the price of medicines. For patients diagnosed with HIV/AIDS inthis study we could not establish a connection between the price of medictions/drugs and adherence to therapy. Similarly, inpatients with tuberculosis we were unable to determine statistically significant correlation between the cost of transportation  to the location where the drugs weretaken and adherence to prescribed medicament regimen. Conclusions: Unemployment, lack of health insurance and the price of the drug correlated with decreasedadherence to the prescribed therapy in our respondents.