Impact of the financial crisis on adherence to treatment of a rural population in Crete, Greece.

Quality in primary care Pub Date : 2014-01-01
Ioanna G Tsiligianni, Polyvios Papadokostakis, Dimitra Prokopiadou, Ioanna Stefanaki, Nikolaos Tsakountakis, Christos Lionis
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Abstract

Background: The global economic crisis has affected Greece. Data on patients' adherence to medications for chronic diseases are missing. The objective of this study was to identify to what extent the financial crisis and the repeated pharmacists strike have influenced patients adherence to therapy.

Methods:

Design: A quantitative and qualitative study in rural Crete was designed and implemented in February 2013 with the use of a pretested questionnaire with opened and closed questions. Setting Rural practices in a well-defined geographical area of Crete.

Subject: The questionnaire was addressed in all patients that visited the rural practices with chronic or acute diseases for two consecutive weeks. Main Outcome(s) and Measure(s): Age, annual income, adherence to therapy, patient's views and feelings.

Results: 288 patients participated. The mean age was 68±6.87. The majority of the patients have lowered the doses of several medications by themselves as they weren't able to afford the cost ie; all patients receiving insulin had lowered the dosages; 46.42% of patients with COPD or asthma had stopped their medications completely, decreased dosages or used similar medications that had in the past; patients with dislipidemia received their medications as suggested only in 51.8%. Patients with cardiovascular diseases received their medications as suggested in 75.6% while the rest have dismissed or skipped dosages. Most common emotions reported were those of sadness, fear, stress, anxiety and isolation.

Conclusions: The economic crisis has influenced patients' adherence to therapy in rural areas as well as their psychological and emotional status. There is an urgent need for action within the context of primary care.

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金融危机对希腊克里特岛农村人口坚持治疗的影响。
背景:全球经济危机已经影响到希腊。关于慢性疾病患者药物依从性的数据缺失。本研究的目的是确定在何种程度上金融危机和反复药剂师罢工影响了患者的治疗依从性。方法:设计:2013年2月在克里特岛农村设计并实施了一项定量和定性研究,采用预测问卷,包括开放式和封闭式问题。在克里特岛明确的地理区域设置农村实践。对象:对所有连续两周到农村就诊的慢性或急性疾病患者进行问卷调查。主要结局和测量指标:年龄、年收入、治疗依从性、患者观点和感受。结果:288例患者参与。平均年龄68±6.87岁。大多数病人自己降低了几种药物的剂量,因为他们负担不起费用。所有接受胰岛素治疗的患者都降低了剂量;46.42%的COPD或哮喘患者完全停药、减少剂量或使用类似的药物;只有51.8%的二血脂患者接受了建议的药物治疗。75.6%的心血管疾病患者接受了建议的药物治疗,而其余的患者则拒绝或跳过了剂量。报告中最常见的情绪是悲伤、恐惧、压力、焦虑和孤立。结论:经济危机影响了农村地区患者的治疗依从性,也影响了他们的心理和情绪状况。迫切需要在初级保健范围内采取行动。
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