Medication Adherence Among Patients with Multimorbidity in the United Arab Emirates

Kholoud K Allaham; Merga Belina Feyasa; Romona Devi Govender; Anas Mahmoud Abbas Musa; Ahmed Juma AlKaabi; Iffat ElBarazi; Shamma Dahi AlSheryani; Reem Juma Al Falasi; Moien A B Khan

doi:10.2147/PPA.S355891

Medication Adherence Among Patients with Multimorbidity in the United Arab Emirates

Patient Prefer Adherence. 2022 May 6:16:1187-1200. doi: 10.2147/PPA.S355891. eCollection 2022.

Authors

Affiliations

¹ Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
² Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
³ Department of Cardiology, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates.
⁴ Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
⁵ Ambulatory Healthcare Services, Abu Dhabi, United Arab Emirates.
⁶ Primary Care, NHS Northwest London, London, TW3 3EB, UK.

Abstract

Background: Multimorbidity, defined as having two or more chronic diseases, has a major impact on public health and Sustainable Development Goals (SDG). This study aims to assess the prevalence of medication adherence and associated factors among patients with multimorbidity.

Methods: A questionnaire-based, cross-sectional survey was conducted by a trained interviewer across patients with multimorbidity attending outpatient clinics in two tertiary referral hospitals in the United Arab Emirates (UAE). Demographic and social variables and the outcome (self-reported adherence to long-term medication) were measured using the General Medication Adherence Scale (GMAS). Multiple logistic regression was used to assess medication adherence and associated factors.

Results: From a total of 630 participants included in this study, the estimated prevalence of high medication adherence is 78.57% (±1.63478) with a 95% confidence interval (CI) [75.19, 81.61]. The odds of high medication adherence increased with age. The odds of high medication adherence for patients aged 66 years and older than those aged 19-35 years is adjusted odds ratio (AOR) = 3.880, with a 95% CI [1.124, 13.390]. Patients with income more than 50,000 had the odds, AOR = 5.169 with a 95% CI [1.282, 20.843], compared to those earning less than 10,000 Dirhams (AED). Patients aged 36-65 with health insurance coverage had higher medication adherence than groups on the other end. The number of current medications is significantly (p-value = 0.027) associated with high medication adherence with the odds of high medication adherence, AOR = 4.529 with a 95% CI [1.184, 17.326], the highest for those currently taking four medications.

Conclusion: This study highlights younger population having multimorbidity in the context of an increasing life expectancy and suboptimal therapeutic outcomes. Furthermore, the study highlights multimorbidity is associated with low medication adherence and out-of-pocket payment, and non-availability of insurance is a major hindrance to medication adherence.

Keywords: United Arab Emirates; global burden of disease; medication adherence; multimorbidity; sustainable development goals.

Grants and funding

The study was supported by the United Arab Emirates University Research Grant (Grant Code – G0000356/12M090-NP-21-13). The funder did not have a role in the design, collection, analysis, interpretation of data, and/or writing of this manuscript.