Journal of Health and Rehabilitation Research

Medication Adherence And Its Associated Factors Among Patients With Type 2 Diabetes Mellitus In Pakistan

Qurba Kiran — 2025-06-15

Background: Medication adherence is essential for glycemic control and prevention of complications among patients with type 2 diabetes mellitus, yet non-adherence remains common in outpatient clinical settings. Objective: To assess medication adherence and identify factors associated with adherence among patients with type 2 diabetes mellitus attending Lahore General Hospital, Lahore, Pakistan. Methods: This hospital-based analytical cross-sectional study included 347 adult patients with type 2 diabetes mellitus receiving oral antidiabetic drugs, insulin, or both. Data were collected using a structured questionnaire covering demographic, socioeconomic, clinical, behavioral, and treatment-related characteristics. Medication adherence was assessed using a standardized adherence assessment tool. Associations were evaluated using bivariate analysis and binary logistic regression, with adjusted odds ratios reported for independent predictors. Results: Good or high adherence ranged from 28.4% to 55.6%, poor or low adherence from 34.7% to 48.5%, and non-adherence from 42.7% to 62.0%. Mean age ranged from 48.8 to 56.6 years, and diabetes duration ranged from 5.58 to 8.40 years. Age below 50 years, married status, and non-smoking status were associated with adherence, with adjusted odds ratios of 1.88, 4.118, and 12.98, respectively. Education level, socioeconomic status, multiple daily dosing, diabetes knowledge, and treatment satisfaction were also associated with adherence. Conclusion: Medication adherence among patients with type 2 diabetes mellitus was suboptimal and influenced by demographic, behavioral, socioeconomic, and treatment-related factors.

Quality of Life and Symptom Burden Among Patients With Chronic Obstructive Pulmonary Disease in Pakistan

Sundus Hassan — 2026-06-30

Background: Chronic obstructive pulmonary disease is a progressive respiratory disorder associated with persistent respiratory symptoms, psychological morbidity, functional limitation, and impaired health-related quality of life. In Pakistan, hospital-based evidence on COPD-related symptom burden and quality-of-life impairment remains clinically important for patient-centered assessment. Objective: To assess quality of life and symptom burden among diagnosed patients with chronic obstructive pulmonary disease attending a tertiary respiratory care hospital in Lahore, Pakistan. Methods: This hospital-based descriptive cross-sectional study included 277 diagnosed COPD patients recruited from the Pulmonology Outpatient Department, medical ward, and follow-up clinic of Gulab Devi Hospital, Lahore. Available aggregated data were analyzed descriptively. Categorical variables were summarized as frequencies, percentages, and 95% confidence intervals, while quality-of-life scores reported in prior COPD studies were summarized as mean ± standard deviation with 95% confidence intervals where calculable. Results: Recalculated burden estimates showed high psychological morbidity, with depression ranging from 50.9% to 67.1% and anxiety from 19.9% to 70.4%. Respiratory symptom estimates included cough in 67.9%, breathlessness in 62.5%, cough with sputum in 42.2%, and dyspnea in 29.2%. Biomass fuel exposure was represented by 39.7%, COPD duration below five years by 54.9%, and productivity loss by 31.8%. Published COPD quality-of-life scores demonstrated impairment across SGRQ, SGRQ-C, WHOQOL, and EQ-5D-5L measures. Conclusion: COPD burden in this hospital-based context appears multidimensional, involving respiratory, psychological, exposure-related, functional, and quality-of-life domains. Patient-level inferential analysis is required to identify independent predictors of poor quality of life.

Awareness Of Stroke Warning Signs And Risk Factors Among Patients With Hypertension And Diabetes Mellitus At A Tertiary-Care Hospital In Lahore, Pakistan: A Cross-Sectional Study

Khadija Usman — 2026-06-30

Background: Stroke is a major cause of mortality and long-term disability, particularly in low- and middle-income countries where delayed recognition of warning signs and inadequate control of modifiable risk factors contribute to poor outcomes. Patients with hypertension and diabetes mellitus are at increased cerebrovascular risk and represent an important target group for preventive education. Objective: To assess awareness of stroke warning signs and risk factors among patients with hypertension, diabetes mellitus, or both attending tertiary-care outpatient services at Mayo Hospital, Lahore, Pakistan. Methods: This hospital-based descriptive cross-sectional study included 281 participants recruited from the Medicine Outpatient Department, Neurology Outpatient Department, and Diabetic Clinic. Stroke awareness was assessed using a structured questionnaire covering recognition of warning signs, risk factors, and overall knowledge categories. Data were summarized as frequencies and percentages. Results: Most participants recognized that stroke affects the brain (267/281, 94.9%), and 225 participants (80.1%) were aware of FAST symptoms. Sudden weakness was recognized by 208 participants (74.0%), whereas awareness of vision problems and altered consciousness was low, reported by 81 (29.0%) and 21 (7.6%) participants, respectively. Smoking, hypertension, and diabetes mellitus were identified as risk factors by 204 (72.6%), 197 (70.0%), and 195 (69.3%) participants, respectively. Adequate overall risk-factor knowledge was present in 129 participants (45.8%). Conclusion: Stroke awareness among high-risk outpatients was partial and uneven, with substantial gaps in recognition of non-motor warning signs and comprehensive risk knowledge. Structured stroke-education strategies should be integrated into outpatient hypertension and diabetes care.

Knowledge, Attitude, and Self-Care Practices Among Diagnosed Hypertensive Patients Attending Outpatient Clinics in Lahore, Pakistan

Aleena Amjad — 2025-06-15

Background: Hypertension is a major preventable contributor to cardiovascular disease, stroke, renal disease, disability, and premature mortality, yet blood pressure control remains suboptimal in many outpatient settings because long-term management depends on patient knowledge, treatment adherence, lifestyle modification, and regular follow-up. Objective: This study aimed to assess hypertension-related knowledge, medication adherence, self-care practices, and blood pressure control among diagnosed hypertensive patients attending outpatient clinical services in Lahore, Pakistan. Methods: A descriptive cross-sectional study was conducted among 245 adult diagnosed hypertensive patients attending the Medicine OPD, Cardiology OPD, and Family Medicine Clinic at the University of Lahore Teaching Hospital, Lahore, Pakistan. Participants were selected using non-probability consecutive sampling. Data were collected using a structured questionnaire assessing sociodemographic and clinical characteristics, hypertension-related knowledge, medication adherence, self-care practices, and blood pressure control status. Descriptive statistics were used to summarize categorical variables as frequencies and percentages. Results: Among 245 participants, 66 (26.9%) had poor knowledge, 122 (49.8%) had moderate knowledge, and 57 (23.3%) had good knowledge. Good medication adherence was reported by 63 (25.7%) participants, moderate adherence by 90 (36.7%), and non-adherence by 92 (37.6%). Diet non-adherence was reported by 179 (73.1%) participants, physical inactivity by 184 (75.1%), and uncontrolled hypertension by 178 (72.7%). Conclusion: Diagnosed hypertensive patients attending outpatient care showed incomplete disease-related knowledge, suboptimal medication adherence, poor lifestyle-related self-care, and a high burden of uncontrolled blood pressure. Structured education, adherence support, lifestyle counseling, and follow-up reinforcement are needed to improve hypertension self-management and control.

Health Literacy And Treatment Compliance Among Patients With Chronic Kidney Disease Attending A Nephrology Outpatient Department And Dialysis Center In Lahore, Pakistan: An Analytical Cross-Sectional Study

Seerat Fatima — 2026-06-30

Background: Chronic kidney disease (CKD) requires continuous self-management, including medication adherence, dietary and fluid restriction, follow-up care, and dialysis-related practices where applicable. Health literacy may influence patients’ ability to understand CKD-related information and follow treatment recommendations, but local evidence from Pakistan remains limited. Objective: To assess health literacy, CKD awareness, treatment compliance, treatment adherence, and selected clinical burden indicators among dialysis and non-dialysis CKD patients attending nephrology care in Lahore, Pakistan. Methods: A hospital-based analytical cross-sectional study was conducted among 256 adult CKD patients attending the nephrology outpatient department and dialysis center of Sheikh Zayed Hospital, Lahore. Participants were selected using non-probability consecutive sampling. Data were collected through a structured questionnaire/interview covering sociodemographic characteristics, clinical profile, health literacy, treatment compliance, treatment adherence, and barriers to compliance. Descriptive statistics were reported as frequencies and percentages. Results: Among 256 CKD patients, 115 (45.1%) had inadequate health literacy and 129 (50.3%) were unaware of CKD symptoms. Good treatment compliance was observed in 56 patients (21.8%), whereas 200 (78.2%) had poor or suboptimal compliance. Poor treatment adherence was reported in 148 patients (58.0%). Anemia was present in 202 CKD patients (78.7%), while anemia among dialysis patients was reported in 242 patients (94.7%). Six-month mortality was observed in 29 patients (11.4%). Conclusion: CKD patients in this hospital-based population showed substantial gaps in health literacy and CKD awareness, with high frequencies of poor compliance, poor adherence, anemia, and mortality. Structured, culturally appropriate, and family-centered patient education should be integrated into nephrology outpatient and dialysis care. Further inferential analysis using individual-level data is required to confirm the association between health literacy and treatment compliance.

Antibiotic Use Practices and Awareness of Antimicrobial Resistance Among Adult Patients Visiting Outpatient Departments in Pakistan

Samara Shaukat — 2026-06-30

Background: Antibiotic misuse contributes substantially to antimicrobial resistance, particularly in settings where antibiotics may be used without adequate medical supervision, discontinued prematurely, or taken for viral illnesses. Adult outpatients represent an important population for assessing antibiotic-related awareness and practices because outpatient encounters are common points of antibiotic prescribing, patient demand, and self-medication. Objective: This study aimed to assess antibiotic-use practices and awareness of antimicrobial resistance among adult patients attending general medicine and family medicine outpatient departments at Ittefaq Hospital, Lahore, Pakistan. Methods: A hospital-based cross-sectional study was conducted over six months among 322 adult outpatient patients selected through non-probability consecutive sampling. Data were collected using a structured questionnaire assessing antibiotic awareness, correct antibiotic knowledge, antimicrobial-resistance awareness, correct understanding of antimicrobial resistance, self-medication, and completion of prescribed antibiotic courses. Data were analyzed using IBM SPSS Statistics version 27, and categorical variables were summarized as frequencies, percentages, and 95% confidence intervals. Results: Antibiotic awareness was reported by 300 participants (93.1%), while correct antibiotic knowledge was present in 116 participants (35.9%). Awareness of antimicrobial resistance was reported by 188 participants (58.3%), and correct understanding of antimicrobial resistance was present in 158 participants (49.0%). Self-medication with antibiotics was reported by 61 participants (18.9%), and incomplete completion of prescribed antibiotic courses was reported by 97 participants (30.1%). Conclusion: Although general antibiotic awareness was high, correct knowledge of antibiotic use and antimicrobial resistance remained limited, and inappropriate antibiotic-use practices were reported by a meaningful proportion of adult OPD patients. Targeted outpatient counselling, patient education, pharmacist involvement, and antimicrobial-stewardship interventions are needed to improve rational antibiotic use.