title: Realities of ambulatory multi-drug treatment of chronic diseases in rural areas of Lublin Province, eastern Poland - comparison of situations in 2010 and 2013.
abstract: BACKGROUND
  The economic stratification observed for many years among the population in Poland, increasing poverty rates, especially those being effects of the current economic crisis in the country, and the rising prices of medicines, are potential risk factors for medication non-adherence among patients in the poorest class of the Polish population. Materials an method. The subjects were 2 groups of inhabitants of rural areas of Lublin Province in eastern Poland. The first consisted of 209 people aged 52-80 years who were surveyed in 2010, the second - 210 people aged 51-88 years, surveyed in 2013. All patients were outpatients who attended the Endocrine Clinic in Poniatowa. The studies were conducted with the use of the standardized survey questionnaire.
  
  
  RESULTS
  The problem of medication non-adherence among the surveyed was evident and has risen from 43.1% in 2010 to 54.8% in 2013. Both in 2010 and in 2013, the main reasons for this state of affairs were the financial problems of the surveyed people. During the period 2010-2013, both expenditure on medicine as well as the ratio "patients' expenditure on medicine/expenditure on food" had increased. In 2010, 25 respondents per 209 (12%) expressed the opinion that they had always had sufficient means to buy necessary medications, in 2013 - only 3 per 210 (1.5%).
  
  
  CONCLUSIONS
  In 2013, most of surveyed patients (54.8%) did not follow prescribed treatment plans (in 2010-43.1%). In most cases, medication non-adherence were the result of financial problems. Current regulations governing refunding of the costs of medicines may make effective ambulatory treatment of chronic diseases impossible.
authors.affiliation: Chair and Department of Epidemiology, Medical University, Lublin, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Kołłątaj
authors.affiliation: Chair and Department of Epidemiology, Medical University, Lublin, Poland.
authors.forename: Irena Dorota
authors.initials: ID
authors.lastname: Karwat
authors.affiliation: Department of Paediatric Endocrinology and Diabetology, Medical University, Lublin, Poland.
authors.forename: Witold
authors.initials: W
authors.lastname: Kołłątaj
authors.affiliation: Department of Health Promotion, Faculty of Physical Education and Health Promotion, University of Szczecin, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Sygit
authors.affiliation: Department of Health Education, Faculty of Physical Education and Health Promotion, University of Szczecin, Poland.
authors.forename: Marian
authors.initials: M
authors.lastname: Sygit
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D002908:Chronic Disease / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D011044:Poland / Q000453:epidemiology; D019338:Polypharmacy; D011203:Poverty; D012307:Risk Factors; D012424:Rural Population; D016903:Drug Monitoring