Medication adherence and its determinants amongst anti-hypertensive patients in a tertiary care hospital in Navi Mumbai
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20200185Keywords:
Anti-hypertensive drugs, Adherence, Sociodemographic factorsAbstract
Background: Anti-hypertensive drugs can effectively control hypertension, subject to good adherence. Uncontrolled hypertension can lead to numerous complications, some even potentially fatal, such as myocardial infarction, atherosclerosis, thromboembolism, shock and stroke.
Methods: A cross-sectional prospective study was conducted with the help of a pre-validated questionnaire during the course of 6 months in the medicine outpatient department and the inpatient department (wards) at a tertiary care hospital, Navi Mumbai in 200 hypertensive patients to calculate the correlation of the sociodemographic factors with adherence by the chi-squared test.
Results: The overall percentage of adherence to antihypertensive medication was 34.8%. It was the highest (72.1%) in the younger age group, i.e., below 50 years. It was observed that as the age increases, the adherence to treatment decreases. Adherence rates were significantly higher among females and those individuals who had never attended school. Among the employed, 70.3% were adherent to their treatment and among the unemployed, 64.4% were adherent. The percentage of adherence was lower in alcohol consumers (9.5%) as compared to nonusers (76% and 32%, respectively).
Conclusions: The clinician advising anti-hypertensive therapy should provide thorough counselling and stress on the issues created due to poor medication adherence as hypertension can be associated with severe outcomes. Treatments should be given in accordance with each patient’s lifestyles in mind such that they may continue taking their medications till the completion of their therapy.
Metrics
References
James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-20.
Rajeev G, Xavier D. Hypertension: The Most Important Non-Communicable Disease Risk Factor in India. Egyptian Journal of Medical Human Genetics, Elsevier; 2018. Available at: www.sciencedirect.com/science/article/pii/S001948321730593X. Accessed on 31 October 2019.
Dobbels F, Van Damme-Lombaert R, Vanhaecke J, De Geest S. Growing pains: non-adherence with the immunosuppressive regimen in adolescent transplant recipients. Pediatr Transplant. 2005;9(3):381-90.
Bhandari S, Sarma PS, Thankappan KR. Adherence to antihypertensive treatment and its determinants among urban slum dwellers in Kolkata, India. Asia Pac J Public Health. 2015;27:74-84.
Shah AJ, Singh V, Patil SP, Gadkari MR, Ramchandani V, Doshi KJ. Factors affecting compliance to antihypertensive treatment among adults in a tertiary care hospital in Mumbai. Indian J Community Med. 2018;43:53-5
Kumar N, Unnikrishnan B, Thapar R, Mithra P, Kulkarni V, Holla R, et al. Factors associated with adherence to antihypertensive treatment among patients attending a tertiary care hospital in Mangalore, South India. IJCRR. 2014;6:77-85.
Ahmed N, Abdul Khaliq M, Shah SH, Anwar W. Compliance to antihypertensive drugs, salt restriction, exercise and control of systemic hypertension in hypertensive patients at Abbottabad. J Ayub Med Coll Abbottabad. 2008;20:66-9.
Nguyen TP, Schuiling Veninga CC, Nguyen TB, Vu TH, Wright EP, Postma MJ, et al. Adherence to hypertension medication: Quantitative and qualitative investigations in a rural Northern Vietnamese community. PLoS One. 2017;12:e0171203.
Baumhäkel M, Schlimmer N, Kratz M, Hackett G, Jackson G, Böhm M, et al. Cardiovascular risk, drugs and erectile function – A systematic analysis. Int J Clin Pract. 2011;65:289-98.
Joho AA. Factors Affecting Treatment Compliance among Hypertension Patients in Three District Hospitals – Dar es Salaam. Masters Thesis, Muhimbili University of Health and Allied Sciences; 2012. Available at: http://www.ihi.eprints.org/1584. Accessed on 31 October 2019.
Senior V, Marteau TM, Weinman J. Genetic Risk Assessment for FH Trial (GRAFT) Study Group. Self reported adherence to cholesterol lowering medication in patients with familial hypercholesterolaemia: The role of illness perceptions. Cardiovasc Drugs Ther. 2004;18:475-81.
Grassi G, Seravalle G, Mancia G. Cardiovascular consequences of poor compliance to antihypertensive therapy. Blood Press. 2011;20(4):196-203.
