title: A Cross-Sectional Study of Medication Adherence Pattern and Factors Affecting the Adherence in Chronic Obstructive Pulmonary Disease.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is considered as a major health problem, associated with mortality and morbidities. Various disease management strategies have been established to optimize patient's longevity and functional status where patient adherence to the prescribed treatment plays a key role. Poor adherence to medication is common among COPD patients and is affected by number of factors like number of medicines, delivery devices and patient-related factors.
  
  
  OBJECTIVE
  This study aims to investigate the adherence pattern in the management of COPD and factors affecting patient adherence to the prescribed treatment.
  
  
  METHODS
  This study is a cross-sectional study which was conducted in a tertiary care hospital. Those patients suffering from COPD of all age were enrolled in this study and prior informed consent was obtained from patients. The structured questionnaire was used to interview those patients.
  
  
  RESULTS
  Total 100 patients were enrolled in this study, among which most patients (45%) were of age groups 60-70 years. Unintentional non-adherence to medication attributed for 65% of patients and the major reason was forgetfulness (52.3%). Most patients had discontinued the medication due to experience of side effects (63.3%). The result showed significant association between adherence and polypharmacy (p=0.00). However, there was no significant association between adherence and age, sex, mode of administration of drugs, technics to use delivery devices etc.
  
  
  CONCLUSIONS
  Majority of COPD patients were elderly (mean age= 68.4 years). Forgetfulness was associated with medication non-adherence. Most of the patients had discontinued medication because of side effects. Polypharmacy is one of the major factors associated with non-adherence to medication in COPD.
authors.affiliation: Department of Pharmacology School of Medical Sciences, Kathmandu University. Research & Development Division Dhulikhel Hospital, Kathmandu University Hospital.
authors.forename: R
authors.initials: R
authors.lastname: Shrestha
authors.affiliation: Department of Pharmacology School of Medical Sciences, Kathmandu University. Department of Human Biology Schools of Science & Medical Sciences Kathmandu University.
authors.forename: A
authors.initials: A
authors.lastname: Pant
authors.affiliation: Department of Pharmacology School of Medical Sciences, Kathmandu University. Research & Development Division Dhulikhel Hospital, Kathmandu University Hospital.
authors.forename: S
authors.initials: S
authors.lastname: Shakya Shrestha
authors.affiliation: Department of Pharmacology School of Medical Sciences, Kathmandu University. Department of Human Biology Schools of Science & Medical Sciences Kathmandu University.
authors.forename: B
authors.initials: B
authors.lastname: Shrestha
authors.affiliation: Department of Internal Medicine Dhulikhel Hospital, Kathmandu University Hospital.
authors.forename: R B
authors.initials: RB
authors.lastname: Gurung
authors.affiliation: Department of Community Program Dhulikhel Hospital, Kathmandu University Hospital.
authors.forename: B M
authors.initials: BM
authors.lastname: Karmacharya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000453:epidemiology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
chemical_list: D001993:Bronchodilator Agents