Appropriateness of chronic asthma management and medication adherence in patients visiting ambulatory clinic of Gondar University Hospital: a cross-sectional study
Abstract Background Although asthma cannot be cured, appropriate management can ensure adequate control of the disease, prevent disease progression and even reverse the illness, enabling people to enjoy good quality of life. Predisposing factors for inappropriate asthma management, including limited...
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| Format: | Article |
| Language: | English |
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Elsevier
2018-08-01
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| Series: | World Allergy Organization Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40413-018-0196-1 |
| _version_ | 1818545552406609920 |
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| author | Zelalem Tilahun Tesfaye Nebeyu Tsegu Gebreselase Boressa Adugna Horsa |
| author_facet | Zelalem Tilahun Tesfaye Nebeyu Tsegu Gebreselase Boressa Adugna Horsa |
| author_sort | Zelalem Tilahun Tesfaye |
| collection | DOAJ |
| description | Abstract Background Although asthma cannot be cured, appropriate management can ensure adequate control of the disease, prevent disease progression and even reverse the illness, enabling people to enjoy good quality of life. Predisposing factors for inappropriate asthma management, including limited diagnostic options and inadequate supply of medications, are features of health institutions in developing countries like Ethiopia. This study was launched to determine the appropriateness of asthma management in patients visiting ambulatory clinic of the Gondar University Hospital. Methods Cross-sectional study was conducted on asthmatic patients who were on chronic follow-up at Gondar University Hospital. Data were collected by review of patients’ medical records and through a semi-structured questionnaire. The Global Initiative for Asthma guideline was used as a reference for determining the appropriateness of asthma management whereas the eight-item Morisky medication adherence scale (MMAS-8) was used to collect data on patients’ adherence to asthma medications. Results The study participants’ ages ranged from 20 to 80 years with a mean age of 49.3 ± 13.6 years. Mild asthma showed a slight predominance in frequency accounting for 38.7% of cases. Asthma management was found to be inappropriate in 52.0% of the patients. Inappropriateness of therapy is attributed to incorrect dosing of medications, addition of unnecessary medications and omission of necessary medications. Patients who had moderate asthma were more likely to receive appropriate treatment [AOR = 728: 63.2, 8386.06], whereas having a treatment regimen of beclomethasone with salbutamol was found to be predictor of inappropriate treatment [AOR = 0.004: 0.001, 0.07]. More than half (56.7%) of the study subjects reported to have high adherence to their medications. Having no formal education was a predictor of low adherence to asthma medications [AOR = 0.051: 0.003, 0.978] whereas, increased monthly income was found to have a positive association with adherence [AOR = 1.923: 1.037, 3.566]. Discussion High prevalence of inappropriate therapy in this study may be attributed primarily to limited accessibility of asthma medications, as 86% of the patients received medium dose beclomethasone with salbutamol for exacerbations despite being at different severity of asthma and level of control. Conclusion The findings of the study showed more than half of asthmatic patients received inappropriate treatment. Nevertheless, a larger proportion of the patients claimed to be highly adherent to their medications. |
| first_indexed | 2024-12-12T07:41:38Z |
| format | Article |
| id | doaj.art-ba66139fd67d400fb762819a7ddc880b |
| institution | Directory Open Access Journal |
| issn | 1939-4551 |
| language | English |
| last_indexed | 2024-12-12T07:41:38Z |
| publishDate | 2018-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Allergy Organization Journal |
| spelling | doaj.art-ba66139fd67d400fb762819a7ddc880b2022-12-22T00:32:46ZengElsevierWorld Allergy Organization Journal1939-45512018-08-011111710.1186/s40413-018-0196-1Appropriateness of chronic asthma management and medication adherence in patients visiting ambulatory clinic of Gondar University Hospital: a cross-sectional studyZelalem Tilahun Tesfaye0Nebeyu Tsegu Gebreselase1Boressa Adugna Horsa2Department of pharmacology and clinical pharmacy, school of pharmacy, college of health sciences, Addis Ababa UniversityOromia Regional State, East Hararghe Zone, Deder General HospitalDepartment of clinical pharmacy, school of pharmacy, College of Medicine and Health Sciences, University of GondarAbstract Background Although asthma cannot be cured, appropriate management can ensure adequate control of the disease, prevent disease progression and even reverse the illness, enabling people to enjoy good quality of life. Predisposing factors for inappropriate asthma management, including limited diagnostic options and inadequate supply of medications, are features of health institutions in developing countries like Ethiopia. This study was launched to determine the appropriateness of asthma management in patients visiting ambulatory clinic of the Gondar University Hospital. Methods Cross-sectional study was conducted on asthmatic patients who were on chronic follow-up at Gondar University Hospital. Data were collected by review of patients’ medical records and through a semi-structured questionnaire. The Global Initiative for Asthma guideline was used as a reference for determining the appropriateness of asthma management whereas the eight-item Morisky medication adherence scale (MMAS-8) was used to collect data on patients’ adherence to asthma medications. Results The study participants’ ages ranged from 20 to 80 years with a mean age of 49.3 ± 13.6 years. Mild asthma showed a slight predominance in frequency accounting for 38.7% of cases. Asthma management was found to be inappropriate in 52.0% of the patients. Inappropriateness of therapy is attributed to incorrect dosing of medications, addition of unnecessary medications and omission of necessary medications. Patients who had moderate asthma were more likely to receive appropriate treatment [AOR = 728: 63.2, 8386.06], whereas having a treatment regimen of beclomethasone with salbutamol was found to be predictor of inappropriate treatment [AOR = 0.004: 0.001, 0.07]. More than half (56.7%) of the study subjects reported to have high adherence to their medications. Having no formal education was a predictor of low adherence to asthma medications [AOR = 0.051: 0.003, 0.978] whereas, increased monthly income was found to have a positive association with adherence [AOR = 1.923: 1.037, 3.566]. Discussion High prevalence of inappropriate therapy in this study may be attributed primarily to limited accessibility of asthma medications, as 86% of the patients received medium dose beclomethasone with salbutamol for exacerbations despite being at different severity of asthma and level of control. Conclusion The findings of the study showed more than half of asthmatic patients received inappropriate treatment. Nevertheless, a larger proportion of the patients claimed to be highly adherent to their medications.http://link.springer.com/article/10.1186/s40413-018-0196-1Inhalation corticosteroidsStepwise asthma therapyBeclomethasoneGondar Univesity hospital |
| spellingShingle | Zelalem Tilahun Tesfaye Nebeyu Tsegu Gebreselase Boressa Adugna Horsa Appropriateness of chronic asthma management and medication adherence in patients visiting ambulatory clinic of Gondar University Hospital: a cross-sectional study World Allergy Organization Journal Inhalation corticosteroids Stepwise asthma therapy Beclomethasone Gondar Univesity hospital |
| title | Appropriateness of chronic asthma management and medication adherence in patients visiting ambulatory clinic of Gondar University Hospital: a cross-sectional study |
| title_full | Appropriateness of chronic asthma management and medication adherence in patients visiting ambulatory clinic of Gondar University Hospital: a cross-sectional study |
| title_fullStr | Appropriateness of chronic asthma management and medication adherence in patients visiting ambulatory clinic of Gondar University Hospital: a cross-sectional study |
| title_full_unstemmed | Appropriateness of chronic asthma management and medication adherence in patients visiting ambulatory clinic of Gondar University Hospital: a cross-sectional study |
| title_short | Appropriateness of chronic asthma management and medication adherence in patients visiting ambulatory clinic of Gondar University Hospital: a cross-sectional study |
| title_sort | appropriateness of chronic asthma management and medication adherence in patients visiting ambulatory clinic of gondar university hospital a cross sectional study |
| topic | Inhalation corticosteroids Stepwise asthma therapy Beclomethasone Gondar Univesity hospital |
| url | http://link.springer.com/article/10.1186/s40413-018-0196-1 |
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