Medication adherence and associated factors among patients with multimorbidity in Bangladesh: a cross-sectional study

Abstract Introduction Multimorbidity, which is an emerging public health issue, makes maintaining medication adherence challenging because of complex treatment regimens, multiple drug use, and the difficulties of managing several conditions simultaneously. This study aims to comprehensively assess the factors associated with medication adherence among patients with multimorbidity in Bangladesh. Materials and methods A convenience sample of 379 individuals with a diagnosis of two or more co-existing chronic diseases was gathered from secondary and tertiary government hospitals, outpatient clinics, and private medical practices between August and September 2023. Data was gathered through interviewers using a pretested semi-structured questionnaire. Sociodemographic history, personal traits, disease-related data, and the medication adherence rating scale (MARS-5) were all included in the questionnaire. The variables linked to medication adherence were investigated using a multivariable logistic regression model. Results Overall, 34.8% of participants demonstrated poor medication adherence, and male participants were less likely to adhere to medications than females (AOR = 0.47; 95% CI: 0.26–0.85). The higher number of prescribed medications (AOR = 0.85; 95% CI: 0.72–0.99), incomplete understanding of current medication (AOR = 0.55; 95% CI: 0.31–1.00), requiring assistance (AOR = 0.38; 95% CI: 0.20–0.72) or dependence on others for medication administration (AOR = 0.22; 95% CI: 0.06–0.88), and self-medication practices (AOR = 0.43; 95% CI: 0.23–0.82) were significantly associated with poor adherence. On the other hand, increasing age per year (AOR = 1.05; 95% CI: 1.02–1.09) and satisfaction with healthcare services (AOR = 3.95; 95% CI: 1.95–7.98) were strong predictors of good adherence. Conclusion Approximately one third of multimorbid patients were poor adherents to medication, and this was associated with increased medication burden, poor understanding, self-medication, and dependence on others. These findings suggest potential strategies for improving adherence, including patient education, simplification, and ease of administration, increased healthcare satisfaction, and shared decision-making. However, future studies are recommended to confirm these approaches.