Factors Related to Medication Adherence of Patients with Neuromyelitis Optica Spectrum Disorder

Abstract

          This descriptive research aimed to investigate the relationships between various factors, consisting of disease and medication knowledge, ability to perform activities of daily living, number of oral medications taken per day, family support, and trust in the healthcare team, and medication adherence among patients with Neuromyelitis Optica Spectrum Disorder (NMOSD). The study was guided by the World Health Organization’s Multidimensional Adherence Model. The sample consisted of 100 purposively selected NMOSD patients attending the neurology outpatient clinic at a tertiary hospital in Bangkok. The research tools included a screening instrument consisted of the 6-item cognitive impairment test; and data collection instruments consisted of the following: (1) general demographic data form, (2) medication adherence questionnaire, (3) medication factors assessment form, (4) patient’s knowledge questionnaire on NMOSD and medication use, (5) functional assessment for activities of daily living, (6) family APGAR questionnaire, and (7) trust in the health team questionnaire. Data collection was conducted from December 2022 to February 2023. Descriptive statistics, chi-square tests, and Fisher’s exact tests were used for data analysis.
            The results revealed that 96% of the participants were female, aged between 22 and 79 years, with a mean age of 49 years (SD = 11.96). The medication adherence rate among participants was 56%. Statistically significant associations were found between medication adherence and disease and medication knowledge (χ² = 37.543, p < .01), ability to perform daily activities (χ² = 19.7, p < .01), number of medications taken per day (χ² = 4.694, p < .05), and family support (χ² = 17.473, p < .01). No significant association was observed between trust in the healthcare team and medication adherence. Odds ratio (OR) analysis indicated that participants with good knowledge of the the disease and medication were 23 times more likely to adhere to medication compared to those with low to moderate knowledge (OR = 23.4, 95% CI = 7.71 - 71.021). Those with good ability in daily activities were 7 times more likely to adhere than those with low to moderate ability to perform daily activities (OR = 7.28, 95% CI = 2.997 - 17.28). Those taking 1 - 5 tablets per day were 2.7 times more likely to adhere than those taking more than 5 tablets (OR = 2.79, 95% CI = 1.181 - 6.604), and those with high family support were 17 times more likely to adhere than those with moderate support (OR = 17, 95% CI = 3.658 - 79.002). Based on these findings, nurses should play a proactive role in enhancing mutual understanding between patients and their families to support consistent medication adherence. Additionally, programs should be implemented to promote daily functioning, provide ongoing education about the disease, and emphasize the benefits of regular medication intake.