Therapietrouw bij chronische medicatie: ook een probleem bij Belgische patiënten

Medication adherence in chronic conditions such as asthma, type 2 diabetes, heart failure, HIV and cancer appears to be a frequent problem. However, the literature on adherence in patients who use inhaled corticosteroids (ICS), oral hypoglycemic agents, drugs for heart failure, antiretrovirals or oral chemotherapy, contains littleor no relevant data for Belgium.In the context of a Master thesis in Pharmaceutical care at KU Leuven, a quantitative study was performed todetermine the prevalence of adherence to chronic medication in Belgium. This retrospective, cross-sectional study used adatabase containing refill data of a regional pharmacists’ association (KLAV). Out of the 603 pharmacies affiliated with this association,all 50 pharmacies where HIV medication was delivered, were selected. Dispensing datafrom the selected pharmacies were collected from 01/07/2008 to 31/12/2009 for five pathologies, i.e.; asthma, type 2 diabetes, heart failure, HIV and cancer. Adherence was calculated with the Medication Refill Adherence (MRA) method. In order to determine whether there were associations between age, gender, drug class andadherence, Chi-square tests were used. Compared with the other patients, cancer patients were the most adherent in taking their drugs (median adherence rate = 88%). In addition, this was the only group in whichthe median adherence rate was above the set limit of 80%. The patients who were prescribed inhaled corticosteroids were the least adherent (median adherence rate = 38%). More than 50% of patients with asthma/COPD, heart failureand diabetes were classified as ‘under-users’. Furthermore, the results showed a significant association within asthma patients between gender and adherence. In asthma, type 2diabetes, heart failure and HIV patients there was a significant relationship between age and adherence and drug class and adherence. As the current study has some limitations,the results should be handled with caution. Nevertheless, the current study shows that also in Belgium there is a problemwith medication adherence in chronic conditions, especially in asthma patients.

Jaar van publicatie:2013