RESEARCH PAPER
Realities of ambulatory multi-drug treatment of chronic diseases in rural areas of Lublin Province, eastern Poland – comparison of situations in 2010 and 2013
 
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1
Chair and Department of Epidemiology, Medical University, Lublin, Poland
 
2
Department of Paediatric Endocrinology and Diabetology, Medical University, Lublin, Poland
 
3
Department of Health Promotion, Faculty of Physical Education and Health Promotion, University of Szczecin, Poland
 
 
Ann Agric Environ Med. 2015;22(3):530-535
 
KEYWORDS
ABSTRACT
Introduction:
The economic stratification observed for many years among the population in Poland, increasing poverty rates, especially those being effects of the current economic crisis in the country, and the rising prices of medicines, are potential risk factors for medication non-adherence among patients in the poorest class of the Polish population.

Material and Methods:
The subjects were 2 groups of inhabitants of rural areas of Lublin Province in eastern Poland. The first consisted of 209 people aged 52–80 years who were surveyed in 2010, the second – 210 people aged 51–88 years, surveyed in 2013. All patients were outpatients who attended the Endocrine Clinic in Poniatowa. The studies were conducted with the use of the standardized survey questionnaire.

Results:
The problem of medication non-adherence among the surveyed was evident and has risen from 43.1% in 2010 to 54.8% in 2013. Both in 2010 and in 2013, the main reasons for this state of affairs were the financial problems of the surveyed people. During the period 2010–2013, both expenditure on medicine as well as the ratio “patients’ expenditure on medicine/expenditure on food” had increased. In 2010, 25 respondents per 209 (12%) expressed the opinion that they had always had sufficient means to buy necessary medications, in 2013 – only 3 per 210 (1.5%).

Conclusions:
In 2013, most of surveyed patients (54.8%) did not follow prescribed treatment plans (in 2010–43.1%). In most cases, medication non-adherence were the result of financial problems. Current regulations governing refunding of the costs of medicines may make effective ambulatory treatment of chronic diseases impossible.

 
REFERENCES (25)
1.
Sabaté E (ed.). Adherence to Long-Term Therapies: Evidence for Action. Geneva, Switzerland: World Health Organization; 2003.
 
2.
van Eijken M, Tsang S, Wensing M, de Smet PA, Grol RP. Interventions to improve medication compliance in older patients living in the community: a systematic review of the literature. Drugs Aging. 2003; 20: 229–240.
 
3.
Sankar UV, Lipska K, Mini GK, Sarma PS, Thankappan KR. The Adherence to Medications in Diabetic Patients in Rural Kerala, India. Asia Pac J Public Health. 2015; 27(2): NP513–23. doi: 10.1177/1010539513475651.
 
4.
Talam NC, Gatongi PM, Rotich JK, Kimaiyo S. Adherence to antiretroviral drug therapy by adult patients attending HIV/AIDS clinic at a Kenyan tertiary health institution. East Afr Med. J. 2009; 86(5): 240–243.
 
5.
Mahfouz EM, Awadalla HI. Compliance to diabetes self-management in rural El-Mina, Egypt. Cent Eur J Public Health. 2011; 19(1): 35–41.
 
6.
Farooq S, Nazar Z, Irfan M, Akhter J, Gul E, Irfan U, et al. Schizophrenia medication adherence in a resource-poor setting: randomised controlled trial of supervised treatment in out-patients for schizophrenia (STOPS). Br J Psychiatry. 2011; 199(6): 467–472.
 
7.
Kronish IM, Diefenbach MA, Edmondson DE, Phillips LA, Fei K, Horowitz CR. Key barriers to medication adherence in survivors of strokes and transient ischemic attacks. J Gen Intern Med. 2013; 28(5): 675–682.
 
8.
Atreja A, Bellam N, Levy S. Strategies to enhance patient adherence: Making it simple. Medacapt Gen Med. 2005; 7(1): 4.
 
9.
American Pharmacists Association. Medication Compliance-Adherence-Persistence Digest. 2004; 7(4): 1–12.
 
10.
Lau DT, Nau DP. Oral antihyperglycemic medication nonadherence and subsequent hospitalization among individuals with type 2 diabetes. Diabetes Care. 2004; 27(9): 2149–2153.
 
11.
GUS. Stopa bezrobocia w latach 1990–2013 (bezrobocie rejestrowane). Główny Urząd Statystyczny. http://www.stat.gov.pl/gus/584... (access: 26.07.2013) (in Polish).
 
12.
GUS. Sytuacja gospodarstw domowych w 2012 r. w świetle wyników badania budżetów gospodarstw domowych. Główny Urząd Statystyczny. Departament Badań Społecznych i Warunków Życia. Materiał na konferencję prasową w dniu 29 maja 2013. Poland, Warsaw, 2013 (in Poland).
 
13.
Sygit K, Kołłątaj W, Sygit M, Kołłątaj B. The impact of economic factors on the realities of outpatient multi-drug treatment of chronic diseases in rural areas. Ann Agric Environ Med. 2011; 18(1): 29–34.
 
14.
Preacher KJ. Calculation for the chi-square test: An interactive calculation tool for chi-square tests of goodness of fit and independence. 2001. http://quantpsy.org (access: 2013.09.03).
 
15.
Magda I, Szczygielski K. Ocena możliwości poprawy działania polskiego system ochrony zdrowia. Współpłacenie i prywatne ubezpieczenia zdrowotne. Program. Ernst & Young Sprawne Państwo. Warszawa, 2011 (in Polish).
 
16.
WHO. Global Health Observatory Data Repository. World Health Statistics. http://apps.who.int/gho/data/n.... (access 26.07.2013).
 
17.
IMS Health o listopadowej liście leków refundowanych. IMS Health/Rynek Zdrowia. 06–11–2012 12:30 ttp://www.rynekzdrowia.pl/Farmacja/IMS-Hea lt h-o-listopadowej-liscie-lekow-refundowanych,124980,6,drukuj.html (access 28.06.2013) (in Polish)
 
18.
Refundacja leków. Nazdrowie.pl http://www.nazdrowie.pl/artyku... (access: 28.06.2013) (in Polish).
 
19.
GUS. Gospodarstwa domowe dochody i wydatki w 2009 roku. GUS – Lublin, 2010 (in Polish).
 
20.
Markowski K (ed.). Rocznik statystyczny województwa lubelskiego. Statistical yearbook of the Lubelskie Voivodship.2012. Urząd Statystyczny w Lublinie. Lublin, 2012 (in Polish).
 
21.
Montgomery MR. Urban Poverty and Health in Developing Countries. Popul Bull. 2009; 64: 1–20.
 
22.
Rodrigues IL, Monteiro LL, Pacheco RH, da Silva SE. Abandonment of tuberculosis treatment among patients co-infected with TB/HIV. Rev Esc Enferm USP. 2010; 44: 383–387.
 
23.
Widjanarko B, Gompelman M, Dijkers M, van der Werf MJ. Factors that influence treatment adherence of tuberculosis patients living in Java, Indonesia. Patient Prefer Adherence. 2009; 3: 231–238.
 
24.
Das K, Ghosh M, Khanna B, Banerjee M, Mondal GP, Singh OP, et al. Discontinuation of secondary preventive treatment of stroke: An unexplored scenario in India. ClinNeurolNeurosurg. 2010; 112: 766–769.
 
25.
Hershman DL, Kushi LH, Shao T, Buono D, Kershenbaum A, Tsai WY,  et  al. Early discontinuation and non-adherence to adjuvant hormonal therapy are associated with increased mortality in women with breast cancer. J ClinOncol. 2010; 28: 4120–4128.
 
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