Evaluation of Medication Adherence in Adults Who Use Multiple Medications in The Context of Illness Perception, Acknowledgement and Attitude Characteristics

Objective: In this study evaluation of medication adherence in adults who have chronic disease and use multiple medications in the context of illness perception, acknowledgement and attitude characteristics is aimed. Methods: For this purpose, Brief Illness Perception Scale (BIPS) and Modified Morisky Scale (MMS) were applied to patients and results were compared with sociodemographic characteristics and medication consumption data. Results: The data of 159 patients were collected and data of 146 patients that meet the criteria were included to analysis. Of these 146 patients 90 (61,6%) were female and 56 (38,4%) were male. Average age was 56,1 year (±8,2, range 28-66 year). The relation between BIPS and MMS scores and data of patients (gender, age, marital status, education status, people living together status and number of medication used) was searched. It was observed that BIPS scores increased with older ages and this result was statistically significant. Besides, BIPS and MMS-knowledge scores were increased and MMS-motivation scores were decreased with higher number of medication used, and these results were also statistically significant. There was no statistically significant correlation between scale scores and other data of patients in terms of gender, marital status, education, people living together status. In the analysis of correlation between MMS and BIPS scores it was found that; patients who have lower MMS-motivation and MMS-knowledge scores tend to have higher BIPS scores. Although this correlation is not a causal relationship it was found statistically significant. Conclusion: It was found that BIPS and MMS introduced useful data especially in patients with chronic diseases during evaluation of medication adherence. Applying these scales routinely and making medication adherence more objective at chronic patients whose target values are unsuccessful would facilitate determination and intervention of weak points of disease management. Amac: Bu calisma, coklu ilac kullanan bir grup yetiskin kronik hastada, Kisa Hastalik Algi Olcegi (KHAO) ve Modifiye Morisky Uyum Olcegi (MMO) baglaminda tedavi uyumu ve hastalik algisinin etkisini degerlendirmeyi amaclamaktadir. Gerec ve Yontem : Bu degerlendirme icin, Mersin Universitesi Tip Fakultesi Aile Hekimligi Poliklinigine Temmuz 2015- Temmuz 2016 tarihleri arasinda basvuran vakalara, Kisa Hastalik Algi Olcegi (KHAO) ve Modifiye Morisky Uyum Olcegi (MMO) uygulanmistir. Sonuclar, vakalarin farkli sosyodemografik ozellikleri ile ilac kullanim verileri baglaminda karsilastirilmistir. 18 yas ustu, birden fazla ilac kullanan, sozel iletisim kurma konusunda dil veya mental fonksiyon sorunu olmayan vakalar arasindan gonullu olanlar calismaya dahil edilmistir. Bulgular : Calisma suresince, toplam 159 vakanin verileri toplanmis, bu vakalardan kriterleri karsilayan 146'sinin sonuclari analizlere dahil edilmis ve degerlendirilmistir. Vakalarin, 90'i kadin (%61,6) ve 56'si erkek (%38,4) idi. Yas ortalamasi 56,1 yil (±8,2, 28-66 yil araliginda) olarak bulunmustur. Vakalarin cinsiyet, yas, medeni durumu, egitim durumu, birlikte yasadigi kisi varligi ve kullandigi ilac sayisi, verilerinin ortalama KHAO ve MMO skorlari (MMO-motivasyon ve MMO-bilgi alt skorlari) ile iliskisi arastirilmistir. KHAO skorlarinin yas arttikca azaldigi gozlendi (p<0,05) ve bu sonucun istatistiksel olarak anlamli oldugu bulunmustur. Ayrica kullanilan ilac sayisi arttikca, KHAO ve MMO-bilgi skorlarinin arttigi (p<0,05), MMO-motivasyon skorlarinin azaldigi (p<0,05) ve bu sonuclarinda istatistiksel olarak anlamli oldugu bulunmustur. Vakalarin, cinsiyet, medeni durum, egitim durumu, birlikte yasadigi kisi varligi ile olcek skorlari arasinda istatistiksel olarak anlamli bir iliski tespit edilmemistir. MMO motivasyon ve bilgi duzeyi ile KHAO skorlari arasindaki iliskinin analizinde; dusuk MMO-motivasyon ve dusuk MMO-bilgi duzeyine sahip vakalarin daha yuksek KHAO skorlarina sahip oldugu goruldu ve her ne kadar bir sebep sonuc iliskisini gostermese de bu iliskinin istatistiksel olarak anlamli oldugu bulunmustur. Sonuc : Ozellikle kronik hastaligi olan vakalarda, ilac uyumunu degerlendirmede KHAO ve MMO'nin hastalik yonetiminde fikir verebilecek faydali veriler sundugu belirlenmistir. Yas arttikca ve kullanilan ilac sayisi azaldikca vakalarin hastaliktan etkilenme duzeyi ve hastaligi endise verici olarak algilama duzeyleri azalmaktadir. Ayrica kullanilan ilac sayisi arttikca vakalarin tedaviye uyum bilgi duzeylerinin arttigi ve motivasyon duzeylerinin azaldigi bulunmustur. Hedef degerlere ulasmada, sorun tespit edilen kronik hastalikli vakalarda, bu olceklerin rutin olarak uygulanarak tedaviye uyumun objektif olarak ortaya konmasi, hastalik yonetiminde zayif noktalarin tespit edilmesini ve mudahale edilmesini olanakli hale getirecektir.