Level of medication non-adherence among ambulatory patients with dyslipidemia and comorbid illness in Northwest Ethiopia: a multicenter cross-sectional study

Abstract

Background: Antilipidemic therapy adherence to medication among patients with dyslipidemia and type 2 diabetes mellitus (T2DM) remains suboptimal, particularly in developing countries. Poor adherence to lipid-lowering therapy is associated with a significantly higher risk of major adverse cardiovascular outcomes in this population than in the general population. Objectives: This study aimed to assess the level of non-adherence to antilipidemic medications and associated socio-demographic and clinical factors among patients attending comprehensive specialized hospitals (CSHs) in Northwest Ethiopia. Design: This multicenter, prospective, cross-sectional study was conducted at CSHs in Northwest Ethiopia from November 10, 2023 to January 30, 2024. Methods: Data were entered using EpiData version 4.6.0.0 and analyzed using STATA version 17.0. The Adherence in Chronic Diseases Scale was used to assess medication adherence. Multinomial logistic regression analysis was used to identify factors associated with non-adherence, and model fitness was checked before interpretation. Results: The study included 398 patients, yielding a response rate of 98.76%. Of these patients, 290 (72.9%) were classified as non-adherent to their antilipidemic medications. Factors significantly associated with medium and low medication adherence included female sex (adjusted odds ratio (AOR) for medium: 2.94, 95% confidence interval (CI): 1.61-5.38; AOR for low: 3.09, 95% CI: 1.66-5.76), unmarried status (AOR for medium: 2.83, 95% CI: 1.52-5.27; AOR for low: 2.72, 95% CI: 1.43-5.17), current smoking (AOR for medium: 3.25, 95% CI: 1.20-8.82; AOR for low: 6.54, 95% CI: 2.46-17.36), presence of comorbidities (AOR for medium: 3.01, 95% CI: 1.65-5.49; AOR for low: 2.41, 95% CI: 1.29-4.47), and polypharmacy (⩾5 medications) (AOR for medium: 3.00, 95% CI: 1.60-5.63; AOR for low: 4.87, 95% CI: 2.56-9.24). Conclusion: This study revealed a high prevalence of medication non-adherence among patients with T2DM with dyslipidemia in Northwest Ethiopia. Non-adherence was significantly associated with female gender, unmarried status, smoking, comorbid conditions, and polypharmacy. These findings emphasize the need for targeted strategies to improve adherence in high-risk populations to enhance lipid control and lower the likelihood of cardiovascular complications.