DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20163272

Evaluation of medication adherence patterns amongst anti-hypertensive drug users in a tertiary care hospital in north India

Mahesh Chander Gupta, Ankita Bhattacharjee, Harpreet Singh

Abstract


Background: Non-adherence to prescribed medications is a major barrier in management of chronic diseases like hypertension, which can lead to treatment failure and can increase morbidity, mortality and health care costs. The objective of this study was to assess the level of adherence of hypertensive patients to their anti-hypertensive medications and various factors influencing the adherence among these patients.

Methods: A cross sectional, observational, questionnaire based study was carried out amongst 70 patients diagnosed with hypertension. Adherence was measured using Morisky medication adherence score questionnaire (MMAS-8). Co-relation of various factors like age, sex, education level, number of drugs taken, presence of concomitant diseases etc. were assessed. Univariate and multivariate analysis was done to determine the factors associated with adherence.

Results: The mean age of 70 patients (35 male, 35 female) were 52.29±11.39 years. Using MMAS-8, high, medium and low adherence was seen in 58.6%, 20.0% and 21.4% patients respectively. Middle age group patients were more adherent (60.8%) than younger age group and elderly (37.5%) (p-value <0.05). Adherence rates were comparable in men and women. There was a positive correlation of adherence with education level, knowledge of BP goals and presence of diabetes. It showed negative correlation with chronicity of hypertension and number of drugs taken.

Conclusions: Medication adherence rate was found to be low in the present study. The level of adherence to treatment among the participants can be achieved through better health promotion and education strategies.


Keywords


Medication, Adherence, Hypertension, MMAS-8

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References


WHO. World Health Organization, World Health Statistics 2012. Geneva: World Health Organization; 2012.

Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217-23.

Sabaté E, Editor. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003.

WHO. World Health Organization, Global Health Observatory (GHO) data. WHO; 2015.

Optimizing adherence to pharmaceutical care plans. gloria nichols-English, Sylvie Poirier. J Am Pharm Assoc. 2000;40(4).

Blandford L, Dans PE, Ober JD, Wheelock C. Analyzing variations in medication compliance related to individual drug, drug class, and prescribing physician. J Managed Care Pharm. 1999;5(1):47-5.

Chobanian AV. Impact of nonadherence to antihypertensive therapy. Circulation. 2009;120:1558-60.

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

Jin J, Sklar GE, Sen Oh VM, Li SC. Factors affecting therapeutic compliance: a review from the patient’s perspective. Ther Clin R Managem. 2008;4(1):269-86.

DiMatteo MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care. 2004;42(3):200-9.

Kalogianni A. Factors affect in patient adherence to medication regimen. Health Sci J. 2011;5(3).

Krzesinski JM, Leeman M. Practical issues in medication compliance in hypertensive patients. Res Rep Clin Cardiol. 2011;2:63-70.

Lowry KP, Dudley TK, Oddone EZ, Bosworth HB. Intentional and unintentional non-adherence to antihypertensive medication. Ann Pharmacother. 2005;39:1198-203.

Brown MT, Bussell JK. Medication adherence: WHO Cares? Mayo Clin Proc. 2011;86(4):304-14.

Ho PM, Bryson CL, Rumsfeld JS. Medication adherence: its importance in cardiovascular outcomes. Circulation. 2009;119:3028-35.

Compliance with antihypertensive therapy among elderly medicaid enrollees: the roles of age, gender, and race. Monane M, Bohn RL, Gurwitz JH, Glynn RJ, Levin R. Avorn J Am J Public Health. 1996;86(12):1805-8.

Kabir M, Iliyasu Z, Abubakar IS, Jibril M. Compliance to medication among hyper tensive patients. J Com Med Prim Healt Car. 2004;16(1):16-20.

Al-Mehza AM, Al-Muhailije FA, Khalfan MM, Al-Yahya AA. Drug compliance among hypertensive patients; an area based study. Eur J Gen Med. 2009;6(1):6-10.

Ramli A, Ahmad NS, Paraidathathu T. Medication adherence among hypertensive patients of primary health clinics in Malaysia. Patie Pref Adher. 2012;6:613-22.

Susan R, Anu K, Achu T, Soumya G, Vijayakumar K, Anish TS. Antihypertensive drug compliance across clinic and community settings, in Thiruvananthapuram, South India. Health Sciences. 2012;1(3):JS002A.

Kale S, Patil A, Mandlecha RH. Compliance and adverse drug effects of antihypertensives in rural India. J Clin Diagnos Res. 2011;5(4):775-9.

Ho PM, Magid DJ, Shetterly SM, Olson KL, Peterson PN, Masoudi FA, et al. Importance of therapy intensification and medication non-adherence for blood pressure control in patients with coronary disease. Arch Intern Med. 2008;168:271-6.

Burnier M. Medication adherence and persistence as the cornerstone of effective antihypertensive therapy. Am J Hypertens. 2006;19:1190-6.

Mazzaglia G, Ambrosioni E, Alacqua M, Filippi A, Sessa E, Immordino V, et al. Adherence to antihypertensive medications and cardiovascular morbidity among newly diagnosed hypertensive patients. Circulation. 2009;120:1598-605.

Mallion JM, Schmitt D. Patient compliance in the treatment of arterial hypertension. European Soci Hypert Scienti Newslet. 2001;2:7.

Anchalaa R, Kannuri NK, Pant H, Khan H, Franco OH, Angelantonio E, et al. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens. 2014;32(6):1170-7.

Folstein MF, Folstein SE, McHugh PR. Mini mental state. A practical method for grading the cognitive state of the patients for the clinician. J Psychiatr Res. 1975;12(3):189-98.

Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24:67-74.

Morisky DE, Ang A, Krousel‐Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens. 2008;10(5):348-54.

Khalil SA, Elzubier AG. Drug compliance among hypertensive patients in Tabuk, Saudi Arabia. J Hypert. 1997;15(5):561-5.