Abstract

THE IMPACT OF CHRONIC COMORBID CONDITIONS ON QUALITY OF LIFE OF A PATIENTS WITH MEDICATION ADHERENCE IN GENERAL MEDICINE DEPARTMENT

Dr. Neela Navya, Dr. Ramya Priya Talluri, Dr. Sai Prasanna, Dr. MD Muzaffar Pasha, Dr. M. Prathibha* and Dr. M. V. Rambabu

Abstract

Background: Comorbidity is the presence of one or more additional diseases or disorders co-occurring with a primary disease or disorder. Quality of life (QoL) incorporates the patient’s perspective of his/her physical, mental and social well-being. Comorbidities can have profound effects on patient’s ability to manage their self-care and pose significant barriers to lifestyle changes and regimen adherence and associated with worse health outcomes, more complex clinical management, and increased health care costs. Hospitalization and subsequent discharge home often involve discontinuity of care, multiple changes in medication regimens, and inadequate patient education regarding the instruction of drug use, respiratory devices, and disease information and also lack of information about the drug's side effects that can lead to medication nonadherence and low level of treatment satisfaction[1], which in turn shows effects on QoL of patient. Aim and Objectives: To assess QoL and Medication Adherence in patients with chronic comorbid conditions using SF-12 questionnaire and Morisky scale respectively. To counsel patients based on their conditions and assess the improvement in their QoL for three months. To use different measures (PIL's, Flash cards) to improve Medication Adherence. To analyze prescriptions for medication errors and suggest suitable recommendations. Methodology: A Prospective Observational study conducted in multispeciality tertiary care hospital with a sample size of 100 patients for a period of 6 months. Patients were recruited based on inclusion and exclusion criteria. Data was collected from the patient by data collection forms and by providing questionnaire. Results and Discussion: The present study, was aimed at assessing quality of life and medication adherence in chronic comorbid conditions (primary conditions: HTN, CVA, CLD, CKD, CAD). In our study QOL was assessed by providing SF-12 questionaires to the patient and the outcomes were observed. QOL was increased by 23.4% in hypertensive patients, 24.24% in CVA patients; 23.51% in CLD patients; 24.36% in CKD patients and 22.66% in CAD patients. Medication adherence was assessed by morisky scale. Means of motivational score was increased by 1.01 & knowledge score was increased by 1.43. Conclusion: Based on our study, we have observed that, Quality of life was poor in CKD patients, when compared to other primary conditions, which was 60.53%, through SF-12 questionaires. After the follow ups, it was increased by 24.36% in CKD patients. Also, an increase in QOL was found in all the conditions. Improvement was also found in medication adherence.

Keywords: Quality of life; Medication adherence; Chronic comorbidities; Hypertension; Cardiovascular accident; Chronic liver disease; Chronic kidney disease; Coronary artery disease; SF-12 quesstioneries; Morisky scale.