Medication availability and economic barriers to adherence in asthma and COPD patients living in a low resource setting

05 May 2022
Respiratory conditions
  • Asthma
  • COPD
Type of resource
Malaga 2022
Aizhamal Tabyshova, National Center of Cardiology and Internal Medicine
Clinical Research Results Abstract Introduction: Respiratory inhaled medication is the cornerstone to control asthma and COPD, but availability and proper adherence are challenges in low and middle income countries (LMIC). Data on medication availability and adherence in Central Asia are lacking. We aimed to investigate availability of respiratory medication and the extent of financially driven non-adherence in patients with COPD and asthma in Kyrgyzstan.Methods: A cross-sectional study was conducted in two regions of Kyrgyzstan. Patients with a physician- and spirometry confirmed diagnosis of asthma and/or COPD were included. Main outcomes were (1) availability of respiratory medication in hospitals and pharmacies, assessed by a survey and (2) medication adherence, assessed by the Test of Adherence to Inhalers (TAI). Logistic regression analyses were used to identify predictors for adherence.Results: Of the 300 participants (COPD: 264; asthma: 36), 68.9% were buying respiratory medication out-of-pocket. Of all patients that visited the hospital, almost half reported that medication was not available. For the pharmacy, this was 8%. Poor adherence prevailed over intermediate and good adherence (80.7% vs. 12.0% and 7.3%, respectively). Deliberate and erratic non-adherence behavior patterns were the most frequent (89.7% and 88.0%), followed by an unconscious non-adherent behavioral pattern (31.3%). In total, 68.3% reported a financial reason as a barrier to proper adherence. Low BMI was the only factor significantly associated with good adherence. Discussion: In this LMIC population, poor medication availability was common and 80% were poorly adherent. Erratic and deliberate non-adherent behaviors were the most common pattern and financial barriers play a role in over two-thirds of the population. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest No declaration of interest. References and Clinical Trial Registry Information