DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20181191

Cross sectional study on prevalence and medication adherence of hypertension and diabetes in a tertiary care hospital in Karimnagar, India

S. Sre Akshaya Kalyani, Srihitha Pendota, Abhinay Sharma Katnapally, Dharanija Porandla, Sandeep Bheemreddy

Abstract


Background: The study aimed to assess the prevalence of Hypertension (HTN), Diabetes mellitus(DM) and other diseases along with comorbid conditions, disease complications and also to assess medication adherence in a tertiary hospital in Karimnagar, Telangana, India.

Methods: A Cross sectional study is performed by analysing a total of 500 patient’s individual case safety reports (ICSR). Prevalence of Hypertension and Diabetes along with most prescribed drugs are analysed. Medication adherence is analysed by using Morisky Medication adherence questionnaire scale (MMAS-4).

Results: Patients with past history of DM, HTN and other diseases which was found to be 245 (49%) patients. Patients with highest disease prevalence were found to be with HTN (56.73%), DM (31.83%) followed by other diseases like asthma (8.57%), Cerebrovascular accident (4.89%) etc., Total of 66 Patients were ruled out with comorbid diseases. Patients with HTN+DM (47) were found to be highest followed by DM+HTN+CVA (4). MMAS-4 revealed 208 patients were using medication out of 245 patients with previous history. According to MMAS-4 most of the patients were with medium adherence (76). Prevalent drug used for HTN include Amlodipine and for DM Telmisartan+Hydrochlorthiazide.

Conclusions: The study revealed that almost half of the admitted patients were with HTN and DM. The patients were counselled properly to adhere strictly to the prescription. Medication adherence to HTN and DM was found to be good in this study. Since the disease complications were also ruled out, the health care professionals are recommended to spread awareness on DM and HTN and disease management in order to control disease and improve health outcomes.


Keywords


Diabetes mellitus, Hypertension, Karimnagar, Medication adherence, Morisky Medication adherence questionnaire scale (MMAS-4), Prevalence of Hypertension and diabetes mellitus

Full Text:

PDF

References


Venugopal K, Mohammed MZ. Prevalence of hypertension in type-2 diabetes mellitus. CHRISMED J Health Res 2014;1:223-7.

Huang XB, Tang WW, Liu Y, Hu R, Ouyang LY, Liu J-x, et al., Prevalence of diabetes and unrecognized diabetes in hypertensive patients aged 40 to 79 years in southwest China; 2017.

Simonson DC, Etiology and prevalence of hypertension in diabetic patients, Diabetes Care (PubMed). 1988 Nov-Dec;11(10):821-7.

Shah A, Afzal M, Prevalence of diabetes and hypertension and association with various risk factors among different Muslim populations of Manipur, India, J Diabetes Metab Disord. 2013;12:52.

Gupta A, Gupta R, Sarna M, Rastogi S, Gupta VP, Kothari K. Prevalence of diabetes, impaired fasting glucose and insulin resistance syndrome in an urban Indian population. Diabetes research and clinical practice. 2003 Jul 1;61(1):69-76.

Fowler MJ. Microvascular and macrovascular complications of diabetes. Clin Diabetes. 2008;26:77-82.

Long AN, Jack SD, The Comorbidities of Diabetes and Hypertension: Mechanisms and Approach to Target Organ Protection, J Clin Hypertens. 2011 Apr;13(4):244-51.

Radhakrishnan S, Ekambaram M. Prevalence of diabetes and hypertension among a tribal population in Tamil Nadu. Arch Med Health Sci. 2015;3:66-71.

Gupta A, Gupta R, Sharma KK, Lodha, Achari V, Arthur J, et al. Prevalence of diabetes and cardiovascular risk factors in middle-class urban participants in India, BMJ Open Diabetes Research and Care; 2014.

Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes research and clinical practice. 2010 Jan 1;87(1):4-14.

Plakas S, Mastrogiannis D, Mantzorou M. Validation of the 8-Item Morisky Medication Adherence Scale in Chronically Ill Ambulatory Patients in Rural Greece. March 2016;6:158-69.

Unni EJ, Farris KB. Unintentional non-adherence and belief in medicines in older adults. Patient education and counseling. 2011 May 1;83(2):265-8.

Tan XI, Patel I, Chang J. Review of the four item Morisky medication adherence scale (MMAS-4) and eight item Morisky medication adherence scale (MMAS-8). Innovations in Pharmacy. 2014;5(3):5.

Uresin Y, Taylor AA, Kilo C, Tschöpe D, Santonastaso M, Ibram G, et al. Efficacy and safety of the direct renin inhibitor aliskiren and ramipril alone or in combination in patients with diabetes and hypertension. Journal of the Renin-Angiotensin-Aldosterone System. 2007 Dec;8(4):190-200.

Konzem SL, Devore VS, Bauer DW, Controlling hypertension in patients with diabetes, Europe PMC., American Family Physician 2002;66(7):1209-14.

Gress TW, Nieto FJ, Shahar E, Wofford MR, Brancati FL. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. New England Journal of Medicine. 2000 Mar 30;342(13):905-12.

Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;12:4-14.

Anchala R, Kannuri KK, Pant H, Khan H, Oscar H, Franco C et al. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension, J Hypertens. 2014 Jun;32(6):1170-7.

Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353:487-97.

Wild S, Roglic G, Green A, Sicree R, King H, Global Prevalence of Diabetes: Estimates for the year 2000 and projections for 2030, Diabetes Care. 2004;27(5):1,047-1,053.

Pinhas-Hamiel O, Zeitler P. The global spread of type 2 diabetes mellitus in children and adolescents, J. Pediatr. 2005;146(5):693-700.

National High Blood Pressure Education Program Working Group report on hypertension in diabetes, Hypertension. 1994;23(2):145-15.

Sowers JR, Epstein M, Frohlich ED. Diabetes, hypertension, and cardiovascular disease: an update, Hypertension. 2001;37(4):1053-9.

Praska JL, Kripalani S, Seright AL, Jacobsen TA. Identifying and assisting low-literacy patients with medication use: a survey of community pharmacies. Ann Pharmacother. 2005;39:1441-5.

Hill-Briggs F, Gary TL, Bone LR, Hill MN, Levine DM, Bancati FL. Medication adherence and diabetes control in urban African Americans with type 2 diabetes. Health Psychol. 2005;24:349-57.

Rubin RR. Adherence to pharmacologic therapy in patients with type 2 diabetes mellitus. Am J Med. 2005;118:27S-34S.

Grant RW, Singer DE, Meigs JB. Medication adherence before an increase in antihypertensive therapy: a cohort study using pharmacy claims data. Clin Ther. 2005;27:773-81.

Pendota S, Surabhineni SAK, Katnapally AS, Porandla D, Beemreddy SK. Classification and applying pharmacovigilance principles to study adverse drug reaction and its management, IJBCP, 2017;6(11).

Akshaya Kalyani SS, Srihitha P. An Epidemiological Study on Adverse Drug Reactions in Indian Population: Meta-Analysis. International Journal of Pharmaceutical and Clinical Research. 2017;9(10):654-9.

Sweileh WM, Aker O, Hamooz S. Rate of compliance among patients with diabetes mellitus and hypertension. An-Najah Univ J Research-A-(Natural Sciences). 2005;19:1-12.

Al-Mehza AM, Al-Muhailije FA, Khalfan MM, Al-Yahya AA. Drug compliance among hypertensive patients; an area based study. Eur J Genet Med. 2009;6:6-10.

Kumar PN, Halesh LH. Antihypertensive treatment: A study on correlates of non adherence in a tertiary care facility. Int J Biol Med Res. 2010;1:248-52.

Rao CR, Kamath VG, Shetty A, Kamath A. Treatment compliance among patients with hypertension and type 2 diabetes mellitus in a coastal population of Southern India. International Journal of Preventive Medicine. 2014 Aug;5(8):992.