HOME MEDICATION MANAGEMENT PRACTICES AND ITS ASSOCIATED FACTORS AMONG COMMUNITY PEOPLE WITH SELECTED CHRONIC DISEASES IN NEPAL

Background: Medication management is an important aspect of maintaining good health and avoiding potential complications or adverse reactions. However, many individuals struggle with properly managing their medications at home, leading to issues such as missed doses, incorrect dosing, and adverse reactions. This study was carried out to assess home medication management practices and associated factors among community people with hypertension or diabetes or both in Budhanilkantha Municipality, Kathmandu, Nepal. Methods: A community based quantitative cross-sectional analytical study was conducted in all 13 wards of Budhanilkantha Municipality of Kathmandu district. A total of 385 patients above 18 years of age with hypertension or diabetes or both were included. A semi-structured questionnaire was used for data collection. The appropriateness of medication management practice (MMP) was evaluated utilizing an interviewing procedure and a variety of questions. The appropriateness of MMP was assessed using six questions that covered drug administration, use of expired medicine, route of administration, storage condition, and discontinuity of drugs. Each correct answer was scored one. A total score of six was considered appropriate MMP whereas below score six MMP was considered inappropriate. Descriptive statistics was performed for all variables and the association of MMP with other study variables was assessed using the Chi-square test and Mann-Whitney U test where appropriate. Data was analysed using IBM-SPSS. Results: Of the 385 patients, males were predominant (210, 54.5%) and patients of age group 41–60 years were higher in number (220, 57.1%). Most of the patients (383, 99.5%) were ever married. Majority of them were suffering from hypertension (223, 57.9%), diabetes (82, 21.3%) and both (80, 20.8%). Patients suffering from chronic disease for more than one year were 340 (88.3%). Most of the patients had followed inappropriate medication management practice (196, 50.9%), while the number of patients following appropriate medication management practice was 189 (49.1%). Administration of drug as per prescription was seen in 233 (60.5%) patients, medicine hoarding in 31 (8.1%), expired medicine in 2 (0.5%), correct route of administration in 382 (99.2%), proper storage in 379 (98.4%), and discontinuity of drugs without physician consultation in 91 (23.6%). There was a significant association between the level of formal education and MMP (χ² = 14.89, p = 0.005) and between duration of disease and MMP (χ² = 4.81, p = 0.028). No statistically significant association was found between age, gender, marital status and types of disease with MMP. Conclusions: Among 385 samples majority of the patient practicing home medication follows inappropriate methods. Duration of disease and education were predictors of home medication management practice in our study.

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