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

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...

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Autores principales: Kokturk, Nurdan, Polatli, Mehmet, Oguzulgen, I Kivilcim, Saleemi, Sarfraz, Al Ghobain, Mohammed, Khan, Javed, Doble, Adam, Tariq, Luqman, Aziz, Fayaz, El Hasnaoui, Abdelkader
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5927343/
https://www.ncbi.nlm.nih.gov/pubmed/29731625
http://dx.doi.org/10.2147/COPD.S150411
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author Kokturk, Nurdan
Polatli, Mehmet
Oguzulgen, I Kivilcim
Saleemi, Sarfraz
Al Ghobain, Mohammed
Khan, Javed
Doble, Adam
Tariq, Luqman
Aziz, Fayaz
El Hasnaoui, Abdelkader
author_facet Kokturk, Nurdan
Polatli, Mehmet
Oguzulgen, I Kivilcim
Saleemi, Sarfraz
Al Ghobain, Mohammed
Khan, Javed
Doble, Adam
Tariq, Luqman
Aziz, Fayaz
El Hasnaoui, Abdelkader
author_sort Kokturk, Nurdan
collection PubMed
description 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.
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spelling pubmed-59273432018-05-04 Adherence to COPD treatment in Turkey and Saudi Arabia: results of the ADCARE study Kokturk, Nurdan Polatli, Mehmet Oguzulgen, I Kivilcim Saleemi, Sarfraz Al Ghobain, Mohammed Khan, Javed Doble, Adam Tariq, Luqman Aziz, Fayaz El Hasnaoui, Abdelkader Int J Chron Obstruct Pulmon Dis Original Research 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. Dove Medical Press 2018-04-27 /pmc/articles/PMC5927343/ /pubmed/29731625 http://dx.doi.org/10.2147/COPD.S150411 Text en © 2018 Kokturk et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Kokturk, Nurdan
Polatli, Mehmet
Oguzulgen, I Kivilcim
Saleemi, Sarfraz
Al Ghobain, Mohammed
Khan, Javed
Doble, Adam
Tariq, Luqman
Aziz, Fayaz
El Hasnaoui, Abdelkader
Adherence to COPD treatment in Turkey and Saudi Arabia: results of the ADCARE study
title Adherence to COPD treatment in Turkey and Saudi Arabia: results of the ADCARE study
title_full Adherence to COPD treatment in Turkey and Saudi Arabia: results of the ADCARE study
title_fullStr Adherence to COPD treatment in Turkey and Saudi Arabia: results of the ADCARE study
title_full_unstemmed Adherence to COPD treatment in Turkey and Saudi Arabia: results of the ADCARE study
title_short Adherence to COPD treatment in Turkey and Saudi Arabia: results of the ADCARE study
title_sort adherence to copd treatment in turkey and saudi arabia: results of the adcare study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5927343/
https://www.ncbi.nlm.nih.gov/pubmed/29731625
http://dx.doi.org/10.2147/COPD.S150411
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