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Zewdie S, Bayked EM, Ayenew W, Seyfu A, Andargie A. Prevalence and predictors of medication adherence among adolescents and adults with asthma in Ethiopia: a systematic review and meta-analysis. J Asthma 2024:1-14. [PMID: 38512046 DOI: 10.1080/02770903.2024.2332920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/15/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVE This review aimed to estimate the pooled prevalence and predictors of medication adherence among adolescents and adults with asthma in Ethiopia. DATA SOURCES Primary studies were searched from PubMed, Scopus, HINARI, and Google Scholar from January 1, 2010 to December 10, 2023. In addition, we have used citation tracking. STUDY SELECTIONS Observational studies (cross sectional, case control, and cohort) conducted among asthmatic patients ≥15 years old in Ethiopia, published in English language were included. After screening, the studies were assessed using Joanna Briggs Institute (JBI) critical appraisal tool and data were extracted using a checklist. Heterogeneity was assessed using forest plot, Q-statistics and I2. RESULTS The review was performed among 13 institution-based studies with a total of 2901 participants with asthma. About 1058 participants had comorbid disease and 354 were cigarette smokers. The pooled prevalence of adherence to medications among patients with asthma was 40.50% (95% CI: 28.05, 52.96; p value < 0.001) with high heterogeneity (I2 = 98.25%, p < 0.001). Getting health education about asthma and having comorbid disease were predictors of medication adherence among adolescents and adults with asthma in Ethiopia. CONCLUSIONS The pooled prevalence of medication adherence among adolescents and adults with asthma in Ethiopia is low and indicated that three out of five adolescents and adults with asthma were non-adherent to medications. This implies the Ministry of Health should develop different strategies to improve medication adherence including patient education and strengthening the health care system. Multicenter longitudinal studies should be further conducted by using objective methods of adherence measurement and large sample size.
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Affiliation(s)
- Segenet Zewdie
- Department of Pharmacy, Injibara University, Injibara, Ethiopia
| | | | - Wondim Ayenew
- Department of Pharmaceutics, University of Gondar, Gondar, Ethiopia
| | - Abyou Seyfu
- Department of Pharmacy, Debre Birhan University, Debre Birhan, Ethiopia
| | - Assefa Andargie
- Department of Public Health, Injibara University, Injibara, Ethiopia
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Tafere C, Bahiru B, Yehualaw A, Demsie DG, Feyisa K, Yismaw MB, Aschale E, Debasu Z, Yilma Z, Agmassie Z, Mulatu S, Yismaw YE, Adal O, Endeshaw D. Medication Non-adherence and predictor factors among adult Asthmatic patients in Ethiopia: a Systematic review and Meta-Analysis. J Asthma 2024:1-14. [PMID: 38526038 DOI: 10.1080/02770903.2024.2332353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/14/2024] [Indexed: 03/26/2024]
Abstract
Objective: A pronounced burden is evident in individuals with asthma, with approximately half of them not adhering to their prescribed medication. Therefore this study aimed to assess the pooled prevalence of anti-asthma medications non-adherence in Ethiopia.Data sources: A comprehensive search was conducted across multiple electronic databases including PubMed, Africa Index Medicus, Science Direct, Hinari, and a search engine, Google Scholar from October 5 to 20, 2023. In addition, digital research repositories from Addis Ababa and Bahir Dar University were accessed.Data selection: The eligibility criteria was employed to screen studies after uploading search results to EndNote software to remove duplicates first. Then, two investigators, CT and BBT, independently assessed titles, abstracts, and the full text of all retrieved references to identify potentially eligible studies.Result: This meta-analysis, which was conducted in Ethiopia, and included 11 full-text articles, revealed a pooled asthma medication non-adherence level of 51.20% (95% CI, 35.20%, 67.20%) with substantial heterogeneity (I2 = 99.08%). The review has also identified factors predicting non-adherence among asthmatic patients: free (health service) (AOR: 0.31, 95% CI; 0.18-0.54), poor knowledge (AOR: 2.85, 95% CI; 1.61-5.05), absence of formal education (AOR: 3.01, 95% CI; 1.72-5.25), history of Previous ADR(AOR: 8.57, 95% CI; 1.12-65.3), and the presence of Co- morbidity(AOR: 3.28, 95% CI; 2.014-5.68), had shown association with asthma medication non-adherence.Conclusion: Asthma medication non-adherence is notably high in Ethiopia. Addressing medication non-adherence requires a comprehensive approach, including clear communication between healthcare providers, patient education and addressing financial barriers to ensure better adherence in asthma patients.
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Affiliation(s)
- Chernet Tafere
- Department of Pharmacy, College of Medicine and Health sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Bereket Bahiru
- Department of Pharmacy, College of Medicine and Health sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Adane Yehualaw
- Department of Pharmacy, College of Medicine and Health sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Desalegn Getnet Demsie
- Department of Pharmacy, College of Medicine and Health sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kebede Feyisa
- Department of Pharmacy, College of Medicine and Health sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Malede Berihun Yismaw
- Department of Pharmacy, College of Medicine and Health sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Endalamaw Aschale
- Department of Pharmacy, College of Medicine and Health sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Zenaw Debasu
- Department of Pharmacy, College of Medicine and Health sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Zewdu Yilma
- Department of Pharmacy, College of Medicine and Health sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Zegaye Agmassie
- Department of Pharmacy, College of Medicine and Health sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Sileshi Mulatu
- Department of Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yazachew Engida Yismaw
- Department of Pharmacy, College of Medicine and Health sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ousman Adal
- Department of Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Destaw Endeshaw
- Department of Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Zewdie S, Mekuria B, Alemu BK, Bayked EM, NurAhmed Toleha H, Ayenew W, Andargie A. Prevalence of medication adherence among adult asthmatic patients in four African countries: A systematic review and meta-analysis. World Allergy Organ J 2024; 17:100870. [PMID: 38304621 PMCID: PMC10831257 DOI: 10.1016/j.waojou.2024.100870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 12/29/2023] [Accepted: 01/01/2024] [Indexed: 02/03/2024] Open
Abstract
Non-adherence to medications has many deleterious effects including poor treatment outcomes, increased economic burden, increased morbidity, hospitalization rate, health care utilization, productivity loss, and mortality. Therefore, this review aimed to estimate the pooled prevalence of medication adherence among asthmatic adults in 4 African countries. Primary studies were extensively searched from databases such as PubMed, HINARI, Cochrane Library, CINHALand, Google Scholar, and Google search engines. After screening and assessing the quality of studies, data were extracted using a checklist. Heterogeneity was assessed using forest plot, Chocran's Q Test and I2. The random effects meta-analysis model was employed to pool the prevalence of medication adherence among adult asthmatic patients in Africa. Sub-group analysis and meta-regression were performed to identify the sources of heterogeneity. Publication bias was assessed using funnel plots with Egger's test. A sensitivity analysis was performed to assess the influence of individual studies on the overall estimate. The review was performed among 16 studies of which 14 were cross-sectional with a total of 4019 participants. The pooled random effects prevalence of adherence to medications among adult patients with asthma in Africa was 39% (95% CI: 32, 47; p < 0.001) with a heterogeneity (I2 = 94.82, p < 0.001). The pooled prevalence of medication adherence among adult asthmatic patients in Africa is low. Researchers should conduct further multicenter longitudinal studies by using objective methods of adherence measurement.
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Affiliation(s)
- Segenet Zewdie
- Department of Pharmacy, Injibara University, Injibara, Ethiopia
| | | | | | | | | | - Wondim Ayenew
- Department of Pharmaceutics, University of Gondar, Gondar, Ethiopia
| | - Assefa Andargie
- Department of Public Health, Injibara University, Injibara, Ethiopia
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