Medication-Related Burden among Patients with Chronic Disease ‎Conditions: Perspectives of Patients attending Non-Communicable ‎Disease Clinics in a Primary Healthcare Setting in Qatar

Abstract

This study aimed to adapt a medication-related burden instrument, the Living with ‎Medicines Questionnaire (LMQ), into the Arabic context, report the psychometric ‎properties of the Arabic version, and assess the burden resulting from the treatment of ‎chronic conditions in Qatar. ‎ The research included two phases. In Phase 1; cultural adaptation was conducted to ‎generate an Arabic version of LMQ (LMQ-AR). In Phase 2, the LMQ-AR was used in a ‎cross-sectional study among patients with chronic conditions in Qatar. Data obtained ‎were used to assess the psychometric properties of the LMQ-AR, as well as to report ‎medication-related burden perceived by patients. Construct validity of the LMQ-AR was ‎evaluated by associating the LMQ-AR score with adherence, measured by the ‎Adherence to Refills and Medications Scale (ARMS), and with global burden assessed by ‎Visual Analogue Scale (VAS). Internal consistency was assessed using Cronbach’s Alpha.‎ A total of 293 patients with diabetes, from different ethnicities, age groups, and ‎educational levels completed the study forms. Of the total sample, 138 patients used the ‎Arabic versions. The domains of LMQ-AR showed acceptable internal consistency with ‎Cronbach’s α ranging from 0.59 to 0.80. The overall LMQ-AR score was positively ‎correlated with ARMS score (rs=0.400, P<0.0001), and VAS (rs=0.335, P<0.0001). ‎Majority of the patients (n = 253) reported the existence of minimum (66.6%) to ‎moderate (24.1%) medication-related burden. There was a moderate positive ‎correlation between the scores of LMQ and ARMS, rs(251) =0.317, p < 0.0005. Diagnosis ‎duration of diabetes (β = 0.203, p < 0.05), adherence score (β = 0.342, p < 0.05), marital ‎status (β = 0.161, p < 0.05), employment status (β = -0.191, p < 0.05), and the presence ‎of hypertension (β = -0.131, p < 0.05) were significant predictors of overall medication ‎burden. ‎ The Arabic version of the LMQ is a reliable and valid instrument that can be used to ‎assess medication-related burden among patients with chronic conditions in the Arabic ‎context. A considerable proportion of patients suffer from medication-related burden, ‎which could be affected by many factors.