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Assessment of Non-Adherence to Oral Metformin and Atorvastatin Therapies: A Cross-Sectional Survey in Piedmont (Italy)

Authors Parente M, Pignata I, Gnavi R, Spadea T, Di Martino M, Baratta F, Brusa P

Received 12 August 2019

Accepted for publication 16 November 2019

Published 14 February 2020 Volume 2020:14 Pages 261—266

DOI https://doi.org/10.2147/PPA.S226206

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen


Marco Parente,1 Irene Pignata,1 Roberto Gnavi,2 Teresa Spadea,2 Mirko Di Martino,3 Francesca Baratta,1 Paola Brusa1

1Department of Drug Science and Technology, University of Turin, Turin, Italy; 2Epidemiology Unit, ASL TO3, Grugliasco, Italy; 3Department of Epidemiology, Lazio Regional Health Service, Rome, Italy

Correspondence: Paola Brusa
Department of Drug Science and Technology, University of Turin, Via Pietro Giuria 9, Turin 10125, Italy
Tel +39 011 670 66 65
Email paola.brusa@unito.it

Introduction: It is not possible to recover from chronic diseases; however, a healthy lifestyle and correct adherence to therapy can avoid complications and co-morbidities. The aim of this study was the cross-sectional evaluation, by means of a questionnaire, of real-world data on the prevalence of non-adherence to metformin and atorvastatin oral therapies in a sample of patients that attend community pharmacies in the Piedmont Region. The secondary aim was to evaluate the presence of correlations between non-adherence and a number of variables detected by the questionnaire.
Materials and Methods: Data were gathered from face-to-face interviews in six community pharmacies in Piedmont. The questionnaire was divided into two sections: the first included the Morisky, Green and Levine Medication Adherence Questionnaire (MAQ) (to assess therapy adherence); the second included questions on gender, age, level of education and the pharmacy in which the questionnaire was administered. Comparisons between proportions and mean values were performed using the χ 2 test. Modified Poisson regression with robust standard errors was used for multivariate analysis. The level of significance was fixed at 0.05, CI at 95%.
Results: The sample analysed was composed of 408 subjects (receiving either metformin or atorvastatin). According to MAQ, 62 patients were non-adherent (15% of the total cohort). Crude and multivariate analysis did not show any statistically significant correlation between gender, age, level of education and non-adherence. It emerged that there was a correlation between non-adherence and being a customer of two of the pharmacies involved [PR = 3.31 (p=0.028) and PR = 3.11 (p=0.027)].
Conclusions: Community pharmacies can be an appropriate setting to identify non-adherent patients. Therefore, healthcare professionals could realize an integrated and structured intervention to improve adherence. However, MAQ could underestimate the number of non-adherent patients. Further studies to test the association between non-adherence prevalence and being the customer of a specific pharmacy should be performed.

Keywords: community pharmacies, Morisky, Green and Levine Medication Adherence Questionnaire, adherence to therapy


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