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. 2024 Sep 4;14(1):20613.
doi: 10.1038/s41598-024-71120-z.

Prevalence and associated factors of non-adherence to antihyperlipidemic medication: a nationwide cross sectional survey in Pakistan

Muhammad Arshed  1 , Muhammad Farooq Umer  2 , Mehwish Kiran  3 , Abdul Majeed Akhter  1 , Ali Hassan Gillani  4 , Shafqat Qamer  5 , Ayesha Babar Kawish  6 , Shumaila Zofeen  7 , Awais Farid  8 , Muhammad Naseem Khan  9
Affiliations

Prevalence and associated factors of non-adherence to antihyperlipidemic medication: a nationwide cross sectional survey in Pakistan

Muhammad Arshed et al. Sci Rep. .

Abstract

Hyperlipidemia significantly contributes to the risk of developing cardiovascular diseases. However, about half of the patients do not adhere to their antihyperlipidemic medications, leading to healthcare costs and premature mortality. This study's objective was to determine the prevalence and associated factors of non-adherence to antihyperlipidemic medications. The study covered hypertensive patients (21,451) aged 21-75 years, presenting to the primary and secondary healthcare facilities across Pakistan (covering 21 divisions) from January 2022 to April 2023. The outcome intended was non-adherence to antihyperlipidemic medication, which was assessed by SEAMS and pill-counting methods (non-adherence < 80%). The study found overall non-adherence to antihyperlipidemic medication of 60.6% across Pakistan, with the highest non-adherence rates found in Azad Jammu and Kashmir (71.9%) and the lowest in Islamabad (47.7%). Multivariable logistic regression analysis revealed that female, no health card (Sehat Sahulat Program government insurance), < 5 years of illness, < 5 daily medications, and dose frequency of twice daily revealed a positively significant association with non-adherence. While monthly income 51,000-100,000, graduation level of education, Muhajir, and hyperlipidemia with one comorbid condition had a significant negative association with the non-adherence. Antihyperlipidemic non-adherence is a multifaceted, multifactorial, profound problem requiring a multipronged approach.

Keywords: Antihyperlipidemic medications; Compliance; Lipid lowering drugs; Non-adherence.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Sampled health facilities from the divisions across Pakistan. (Figure constructed through Geoda subversion 1.16.0 (https://geodacenter.github.io/download.html).
Fig. 2
Fig. 2
Study flow diagram.
Fig. 3
Fig. 3
Provincial and division-level prevalence of antihyperlipidemic medications in Pakistan.
See this image and copyright information in PMC

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