(052) Assessment of medication adherence and its factors influencing poor medication adherence among psoriasis patients: a cross-sectional study

Publication Number: 715

Background: Multiple drug regimen is common in psoriasis patients due to high disease activity, low remission, multiple comorbidities and complications. This enhances the risk of poor adherence to medication use. The data on the assessment of medication adherence among psoriasis patients is limited.

Objectives: This study aimed to assess medication adherence and its factors influencing poor medication adherence among psoriasis patients.

Methods: A prospective cross-sectional study was conducted at the dermatology department in a tertiary care teaching hospital for 36 months. Patients of either gender, aged ≥16 years, diagnosed with psoriasis and admitted to hospital or visited outpatient department and receiving at least one medication were included in this study. Clinical pharmacist prospectively collected study relevant data from study eligible patient on a daily basis during ward round or outpatient department visit into suitably designed data collection form. Medication adherence was measured after their enrolment into the study by using Medication Adherence Rating Scale (MARS) which contains 10-item questionnaires. It assessed medication adherence in terms of mean MARS score and compliance status towards medication usage. The MARS was used both in English and converted local language. The continuous data were presented in mean and standard deviation (SD) while descriptive data were presented in number and percentage (%). SPSS V25 was used for statistical analysis. Binary logistic regression was used for identifying the risk factors associated with poor medication adherence.

Results: Of the 52 psoriasis patients enrolled, majority of patients were females 38 (73.1%). The mean age of psoriasis patients was 50.73 (SD±17.22) years. Majority of study patients 33 (63.5%) had a history of taking more than five medications. A total of 560 drugs, an average of 10.7 drugs per patient (range: 2-14 drugs) were prescribed. The overall mean MARS score was 4.02 (SD± 1.23). Of the 52 psoriasis patients, only 15 (28.8%) patients were compliant toward medication use. Patients taking more than five drugs and presenting with more than three comorbidities increased 4.47 and 3.3 fold risk for poor medication adherence respectively which was highly significant (P < 0.0001)

Conclusions: This study reveals that the psoriasis patients had poor medication adherence and poor compliance toward medication use. Polypharmacy and multiple comorbidities were the most common risk factors associated with poor medication adherence. Therefore, clinical pharmacists and clinicians need to actively participate in the assessment of patients’ medication adherence for better therapeutic benefits.