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 23 May 2018

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News

Factors associated with non-adherence in end-stage liver disease

This month's issue of the Digestive Diseases & Sciences identifies factors associated with medication non-adherence in patients with end-stage liver disease.

News image

Low medication adherence is known to contribute to worse health outcomes in the general population.

Dr Selena Kuo evaluated the medication regimen, and determined the adherence levels among patients with end-stage liver disease.

The research team measured adherence in patients awaiting liver transplantation at a single center using the 8-item Morisky Medication Adherence Scale (MMAS-8), with a score <8 classified as low adherence. 

Medication regimen complexity was assessed using the Medication Regimen Complexity Index (MRCI) tool. 

30% were high adherers
Digestive Diseases & Sciences
Factors associated with low adherence were identified by logistic regression.

Of 181 patients, the team reported that 33% were female with a median age of 62 years, and a model for end-stage liver disease (MELD) score was 13. 

The median number of medications was 10, and the MRCI was 19. 

In total, the researchers noted that 30% were high adherers, and 70% were low adherers.

The team observed that 42% reported sometimes forgetting to take their medication, and 22% reported intermittent adherence within the past 2 weeks. 

The most common reasons for low adherence were forgetfulness, and side effects. 

Compared to high adherence, low adherence was associated with higher number of medications, medication complexity, and diabetes, but lower rates of hepatocellular carcinoma and self-perceived health. 

The research team found that the total medication number, MRCI, diabetes, hepatocellular carcinoma, and lower self-perceived health, were statistically significant factors associated with non-adherence. 

The team observed that only medication number without supplements remained significantly associated with medication non-adherence.

Dr Kuo's team commented, "A majority of patients awaiting liver transplantation demonstrated low medication adherence."

"Total number of medications and regimen complexity were strong correlates of low adherence."

"Our data underscores the need for chronic liver disease management programs to improve medication adherence in this vulnerable population."

Dig Dis Sci 2017: 62(2): 543–549
10 February 2017

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