Non-adherence to bronchial asthma treatment and associated factors in selected hospitals of Addis Ababa: A multi-centered cross-sectional study

Abstract

Abstract Background: Asthma is a major global public health concern and killed 455,000 people in 2019 due to poor medication compliance, mainly in low- and middle-income countries. Suboptimal medication adherence negatively impacts patient quality of life and increases healthcare costs. The data on adherence to anti-asthmatic medication and its associated factors among asthmatic patients in Addis Ababa is limited. Objective: To assess non-adherence to bronchial asthma treatment medication and associated factors in selected hospitals of Addis Ababa, 2023 Methods: A multi-center cross-sectional study was conducted at four selected hospitals in Addis Ababa from March 11 to October 11, 2024. A total of 422 asthma patients aged 18 years and older and using asthma medicines for at least 12 months were recruited randomly. An interviewer-based structured questionnaire will be used to collect the data. The Adherence to Asthma Medication Questionnaire (AAMQ-13) was used to assess the participant's medication adherence. Binary logistic regression analysis was used to identify factors associated with non-adherence to medication. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) will be used to determine the strength of the association. Variables with a p-value of < 0.05 were considered statistically significant. Results: The study found that the prevalence of nonadherence rate was 135 (33%; 95% CI: 28.6, 37.8%). Not attended formal education (AOR: 3.56; 95% CI: 1.85, 6.88, not attending regular follow-up as scheduled (AOR: 2.77; 95% CI: 1.37, 5.60), poor knowledge (AOR: 2.8; 95% CI: 1.74, 4.50), duration of medication for 6-10 years (AOR: 0.43; 95% CI: 0.22, 0.83) and over 10 years (AOR: 0.42; 95% CI: 0.21, 0.83) were associated with poor adherence Conclusion: The study found that a third of asthmatic patients are non-adherent to their medication, and half have exacerbated asthma. Strategies to improve adherence include boosting health literacy and focusing on those who haven't attended formal education. Keywords: non-adherence, suboptimal, asthma, Addis Ababa, Ethiopia