Treatment satisfaction and pharmacological adherence in patients with chronic diseases

Type of funding sources: None.

There are many factors that influence patient adherence to treatment, including complexity and frequency of dosing, convenience and treatment satisfaction. Patient satisfaction with the results of treatment is a strong motivation for systematic continuation of treatment. Lack of satisfaction with treatment may negatively affect the level of adherence. This relationship is often suggested in articles, but there is still a lack of evidence on the relationship between treatment satisfaction and treatment adherence in chronically ill patients.

The aim of the study was to assess the treatment satisfaction and evaluate the relationship between treatment satisfaction and pharmacological adherence in patients with hypertension, type 2 diabetes and heart failure.

The study included 197 inpatients (110 male, mean age 61.23±14.34) with hypertension (n=55), type 2 diabetes (n=42) and heart failure (n=100). The following instruments were used: the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) to assess the patient satisfaction with the treatment received and the Adherence to Refills and Medication Scale (ARMS) for evaluating adherence. Socio-demographic and clinical data were obtained from patients’ medical records.

In the comparative analysis, patients with heart failure were older (67.59±11.93 vs. 62.51±14.62 vs. 60.83±13.23), were male (68.0% vs. 47.27% vs. 30.95%), had 2 or more additional diseases (55. 0% vs. 23.64% vs. 47.62%), more frequently took 5 or more tablets daily (71.0% vs. 50.91% vs. 54.76%), were more frequently hospitalized (61.0% vs. 14.55% vs. 40.48%) compared to the other groups. Patients obtained the highest scores in the domain of undesirable side effects (85.32±28.62) and the lowest in the domains of satisfaction with medical care (61.61±28.36) and impact of treatment on daily activities (66.54±26.90). However, there were no statistically significant differences in adherence of patients differing by chronic disease (HTN: 17.56±5.21 vs. DM: 18.21±5.34 vs. HF: 17.23±4.36; p=0.791). In correlation analysis, all ARMS subscales correlated significantly and negatively with all SATMED-Q subscales, so the higher the adherence level (lower ARMS score) the lower the treatment satisfaction. Linear regression analysis showed that adherence to pharmacological recommendations measured by the ARMS questionnaire was an independent determinant of treatment satisfaction in all study groups, and a higher ARMS score (lower adherence level) decreased treatment satisfaction (HTN: -2.088 vs. DM: -1.879 vs. HF: -0.942).

Treatment satisfaction has a significant impact on pharmacological adherence in patients with hypertension, type 2 diabetes and heart failure. The more satisfied the patient is with the treatment, the better their pharmacological adherence.