THE IMPACT OF COST, BELIEFS, AND REGIMEN COMPLEXITY ON MEDICATION ADHERENCE AMONG HEART FAILURE PATIENTS IN YEMEN: A CROSS-SECTIONAL STUDY

Ramez Abdullah Mohammed alsameai, Dr. apt. Fita Rahmawati, Sp. FRS; Dr. apt. Anna Wahyuni, M.P.H., Ph.D.

2024 | Tesis | S2 Mag.Farmasi Klinik

Latar Belakang: Gagal jantung adalah penyebab utama rawat inap dan kematian di seluruh dunia, dengan kepatuhan terhadap pengobatan yang sangat menantang di negara-negara berpenghasilan rendah seperti Yaman. Studi ini mengevaluasi status kepatuhan terhadap pengobatan serta dampak biaya, keyakinan, dan kompleksitas rejimen pengobatan di antara pasien gagal jantung di Yaman.

Bahan dan Metode: A cross-sectional study dilakukan dari Desember 2023 hingga Februari 2024, melibatkan 254 pasien gagal jantung dari tiga rumah sakit kardiologi di ibu kota Yaman. Kepatuhan pengobatan dinilai menggunakan Medication Adherence Report Scale (MARS-5). Belief about Medication Questionnaire (BMQ-Specific) digunakan untuk mengukur sikap pasien terhadap obat-obatan mereka, sementara Medication Regimen Complexity Index (MRCI) digunakan untuk mengevaluasi kompleksitas regimen pengobatan mereka. Beban finansial dinilai melalui Cost-related treatment questionnaire. Selain itu, data demografis dan data pasien lain yang relevan dikumpulkan untuk mengeksplorasi korelasi dengan kepatuhan pengobatan. Semua data dianalisis menggunakan perangkat lunak statistik. Analisis statistik, termasuk uji Mann-Whitney tests, Spearman's correlation, dan multiple linear regression, digunakan untuk mengevaluasi prediktor kepatuhan.

Hasil: Dari 254 peserta (usia rata-rata 50,9 ± 11,5 tahun; 65,7% pria), skor kepatuhan median adalah 19,0 (IQR: 16-23). Keyakinan akan pentingnya pengobatan berhubungan positif dengan kepatuhan (B = 0,371, p < 0 xss=removed xss=removed xss=removed xss=removed xss=removed>

Kesimpulan: Strategi untuk meningkatkan kepatuhan terhadap pengobatan harus mencakup edukasi pasien tentang pentingnya penggunaan obat yang konsisten, penyederhanaan rejimen pengobatan, dan mengatasi hambatan keuangan.

Background: Heart failure is a leading cause of hospitalizations and mortality worldwide, with medication adherence being particularly challenging in low-income countries like Yemen. This study evaluates the status of medication adherence and the impact of cost, beliefs, and regimen complexity among heart failure patients in Yemen.

Materials and Methods: A cross-sectional study was conducted from December 2023 to February 2024 with 254 heart failure patients from three cardiac hospitals in Sana'a, Yemen. Medication adherence was assessed using the Medication Adherence Report Scale (MARS-5). The Belief About Medication Questionnaire (BMQ-Specific) measured patients’ attitudes, and the Medication Regimen Complexity Index (MRCI) evaluated treatment regimen complexity. Financial burden was assessed through a cost-related medication questionnaire. Statistical analyses, including Mann-Whitney tests, Spearman's correlation, and multiple linear regression, were used to evaluate predictors of adherence.

Result: Of the 254 participants (mean age 50.9 ± 11.5; 65.7% men), the median adherence score was 19.0 (IQR: 16-23). Belief in the necessity of medications was positively associated with adherence (B = 0.371, p < 0 xss=removed xss=removed xss=removed xss=removed xss=removed>

Conclusion: Strategies to improve medication adherence should include patient education on the importance of consistent medication use, simplifying medication regimens, and addressing financial barriers.

Kata Kunci : Keywords: Heart failure, adherence, treatment complexity, beliefs, cost