Assessment of medication adherence among patients with chronic diseases: a descriptive cross-sectional study


  • Shakeel Ahmad Mir Department of Clinical Pharmacology, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Kashmir, India
  • Furqanah Muzamil MBBS Student, SKIMS Medical College Bemina, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Kashmir, India
  • Mehraj UD Din Bhat Department of Clinical Pharmacology, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Kashmir, India
  • Abid Amin Research Scholar, General Medicine, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Kashmir, India
  • Danish Shakeel Student, CSE IBM, Chandigarh University, Mohali, Punjab, India



Adherence, Health care, Medication, Treatment


Background: Adherence is a key factor associated with effectiveness of all pharmacological therapies. Medication non-adherence is a significant barrier to achieve positive health outcomes especially for patients suffering from chronic diseases. Improving medication adherence is a public health priority and could reduce economic and health burdens. The aim of the present study was to assess medication adherence to some common chronic ailments.

Methods: Pre-validated questionnaires were distributed among 300 patients suffering from chronic illnesses, by simple randomization out of which 240 patients returned completely filled questionnaires. The analysis was done by manual calculators, VassarStats, and SPSS V20. Results were calculated using univariate linear regression, with each patient’s adherence score as the dependent variable and each predictor as the independent variable. Results are expressed in frequencies and percentages.

Results: In this study, 46.66% patients were males and 53.33% females. The mean age was 56.69 years ranging from 24 to 90 years.65.00% patients were uneducated.40.00% were taking one drug, 53.33% two to four drugs and 6.66% more than four drugs. 63.33% had low medication adherence, 35.00% medium and only 1.66% had high adherence. Compared to 14.28% men, 43.75% women were moderately adherent to medications. 41.02% uneducated patients had medium adherence as compared to 14.28% educated patients. 92.30% young patients had low adherence as compared to 53.25% in adults. 44.79% of patients receiving a single drug had medium adherence as compared to 25.00% in those receiving multiple drugs. Linear regression analysis demonstrated that the level of medication adherence was associated with patient gender, age, educational level, and number of prescribed drugs.

Conclusions: There are many challenges in understanding the reasons for non-adherence. In this study medication adherence in chronic diseases was found suboptimal and associated with patient`s socio-demographic characteristics. Patient-tailored interventions are required to achieve sufficient adherence to therapeutic drug regimens.


Sabate E. Adherence to long-term therapies: Evidence for action. Geneva: World Health Organization; 2003. Available at:

Brown MT, Bussell JK. Medication adherence: WHO cares? Mayo Clin Proc. 2011;86(4):304-14.

DeBusk RF, West JA, Miller NH, Taylor CB. Chronic disease management: treating the patient with disease(s) vs treating disease(s) in the patient. Arch Intern Med. 1999 Dec 13-27;159(22):2739-42.

Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353:487-97.

Jimmy B, Jose J. Patient medication adherence: measures in daily practice. Oman Med J. 2011;26(3):155-9.

Andrew WR, Ginny DC, Denise AE, Mary TR, Morris W, Joel FF. Patterns of Medication Adherence and Health Care Utilization Among Patients with Chronic Disease Who Were Enrolled in a Pharmacy Assistance Program. N C Med J. 2014;75(5):310-8.

Vrijens B, Antoniou S, Burnier M, de la Sierra A, Volpe M. Current Situation of Medication Adherence in Hypertension. Front. Pharmacol. 2017;8:100.

Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J. Clin. Hypertens. 2008;10:348-54.

Zullig LL, Hayden BB. Medication Adherence: A Practical Measurement Selection Guide Using Case Studies. Patient Educ Couns. 2017 July;100(7):1410-4.

Zachary AM, Walid FG. Medication Adherence to Multi-Drug Regimens. Clin Geriatr Med. 2012 May;28(2):287-300.

Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24:67-74.

Rosita S, Kjell T, Karl AF, Thorarinn G, Ernst O, Cecilie S, et al. Asthma in men and women: Treatment adherence, anxiety, and quality of sleep. Respiratory Medicine. 2010;104:337e344

Manteuffel M, Williams S, Chen W, Verbrugge RR, Pittman DG, Steinkellner A. Influence of patient sex and gender on medication use, adherence, and prescribing alignment with guidelines. J Womens Health (Larchmt). 2014 Feb;23(2):112-9.

Chen SL, Lee WL, Liang T, Liao IC. Factors associated with gender differences in medication adherence: a longitudinal study.J Adv Nurs. 2014 Sep;70(9):2031-40.

Marya JC, Shimon S, Courtney C, Sunil K, Michael KP, Jeffrey LS. Predictors of medication adherence postdischarge: The impact of patient age, insurance status, and prior adherence. J Hosp Med. 2012 July;7(6):470-5.

Bandi P, Goldmann E, Parikh NS, Farsi P, Boden-Albala B. Age-related differences in antihypertensive medication adherence in Hispanics: a cross-sectional community-based survey in New York City, 2011-2012. Prev Chronic Dis. 2017;14:E57

Leven EA, Annunziato R, Helcer J, Lieber SR, Knight CS, Wlodarkiewicz C, et al. Medication adherence and rejection rates in older vs younger adult liver transplant recipients. Clin Transplant. 2017 Jun;31(6).

Shrinivasa BM, Yadav K, Narayana Murthy MR, Kavitha HS. Patient based factors influencing drug compliance among hypertensive patients in a tertiary care hospital in Mysore. Int J Res Med Sci. 2015 Jun;3(6):1435-8.

Mitchell WG, Scheier LM, Baker SA. Adherence to treatment in children with epilepsy: who follows "doctor's orders"? Epilepsia. 2000 Dec;41(12):1616-25.

Mohammed S, Arabi A, E-Menyar A, Abdulkarim S, AlJundi A, Alqahtani A, et al. Impact of Polypharmacy on Adherence to Evidence-Based Medication in Patients who Underwent Percutaneous Coronary Intervention. Curr Vasc Pharmacol. 2016;14(4):388-93.




How to Cite

Mir, S. A., Muzamil, F., Bhat, M. U. D., Amin, A., & Shakeel, D. (2018). Assessment of medication adherence among patients with chronic diseases: a descriptive cross-sectional study. International Journal of Basic & Clinical Pharmacology, 8(1), 115–119.



Original Research Articles