Patient Preference and Adherence (Feb 2020)
Assessment of Non-Adherence to Oral Metformin and Atorvastatin Therapies: A Cross-Sectional Survey in Piedmont (Italy)
Abstract
Marco Parente,1 Irene Pignata,1 Roberto Gnavi,2 Teresa Spadea,2 Mirko Di Martino,3 Francesca Baratta,1 Paola Brusa1 1Department of Drug Science and Technology, University of Turin, Turin, Italy; 2Epidemiology Unit, ASL TO3, Grugliasco, Italy; 3Department of Epidemiology, Lazio Regional Health Service, Rome, ItalyCorrespondence: Paola BrusaDepartment of Drug Science and Technology, University of Turin, Via Pietro Giuria 9, Turin 10125, ItalyTel +39 011 670 66 65Email [email protected]: It is not possible to recover from chronic diseases; however, a healthy lifestyle and correct adherence to therapy can avoid complications and co-morbidities. The aim of this study was the cross-sectional evaluation, by means of a questionnaire, of real-world data on the prevalence of non-adherence to metformin and atorvastatin oral therapies in a sample of patients that attend community pharmacies in the Piedmont Region. The secondary aim was to evaluate the presence of correlations between non-adherence and a number of variables detected by the questionnaire.Materials and Methods: Data were gathered from face-to-face interviews in six community pharmacies in Piedmont. The questionnaire was divided into two sections: the first included the Morisky, Green and Levine Medication Adherence Questionnaire (MAQ) (to assess therapy adherence); the second included questions on gender, age, level of education and the pharmacy in which the questionnaire was administered. Comparisons between proportions and mean values were performed using the χ 2 test. Modified Poisson regression with robust standard errors was used for multivariate analysis. The level of significance was fixed at 0.05, CI at 95%.Results: The sample analysed was composed of 408 subjects (receiving either metformin or atorvastatin). According to MAQ, 62 patients were non-adherent (15% of the total cohort). Crude and multivariate analysis did not show any statistically significant correlation between gender, age, level of education and non-adherence. It emerged that there was a correlation between non-adherence and being a customer of two of the pharmacies involved [PR = 3.31 (p=0.028) and PR = 3.11 (p=0.027)].Conclusions: Community pharmacies can be an appropriate setting to identify non-adherent patients. Therefore, healthcare professionals could realize an integrated and structured intervention to improve adherence. However, MAQ could underestimate the number of non-adherent patients. Further studies to test the association between non-adherence prevalence and being the customer of a specific pharmacy should be performed.Keywords: community pharmacies, Morisky, Green and Levine Medication Adherence Questionnaire, adherence to therapy