Adherence to Anti-Hypertensive Drugs: A Clinic Based Study among Geriatric Hypertensive Patients in Rural, India
Keywords:
hypertension, geriatric, adherence, antihypertensive drugsAbstract
Background: Hypertension is a common chronic health condition, more among the elderly and is the most important risk factor for all subtypes of vascular disease and death. A medication’s success in producing the desired benefit depends on a person’s adherence with the therapeutic regimen. The World Health Organization (WHO) describes poor adherence as the most important cause of uncontrolled blood pressure and estimates that 50% of people do not take their antihypertensive medication as prescribed. Objectives of this study were to assess the adherence to anti-hypertensive therapy and also to elicit the determinants of poor adherence among geriatric hypertensives.
Methodology: An observational, cross-sectional, descriptive study was conducted among geriatric hypertensive attended the OPD during the study period in the rural health centre of West Bengal, India.
Results: 44.63% of the respondents adhered to anti-hypertensive drugs . The most common reasons for poor adherence were due to irregular supply from government pharmacy (72.3%) followed by forgetfulness (67.5%) and non-affordability (66.3%).Poor adherence to drugs was significantly (p<0.05) associated with contextual variables like age, literacy, socio-economic status, duration of treatment and presence of comorbidities.
Conclusion: Advocacy of adherence to antihypertensive drugs should be inculcated in each and every hypertensive patient along with regular and uninterrupted drug supply and high quality health care service in all health care organisations where health education and counselling gets the highest priority.
References
Indian’s Elderly Population: Some Fundamentals©2009–2013. Available at: http://.gktoday.in
Sabaté E, editor. , ed. Adherence to Long-Term Therapies: Evidence for Action. Geneva, Switzerland: World Health Organization; 2003.
Fung V, Huang J, Brand R, Newhouse JP, Hsu J. Hyper-tension treatment in a Medicare population: adherence and systolic blood pressure control. ClinTher. 2007;29(5):972–984.
Krousel-Wood M, Thomas S, Muntner P, Morisky D. Medication adherence: a key factor in achieving blood pressure control and good clinical outcomes in hyperten-sive patients. Curr Opin Cardiol. 2004; 19(4):357–362
Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease [full report; PDF file on the Internet]. NEHI Pub-lication. 2009 Aug. Available from: http://www.nehi.net/publications/44/thinking_outside_the_pillbox_a_systemwide_approach_to_improving_patient_medication_adherence_for_chronic_disease. Ac-cessed March 27, 2015.
Brown M T, and Bussell J K: Medication Adherence: WHO Cares?
Morisky DE, Ang A, Krousel-Wood M, Ward H. Predic-tive Validity of a Medication Adherence Measure for Hy-pertension Control. Journal of Clinical Hypertension 2008; 10(5):348-354
Krousel-Wood MA, Islam T, Webber LS, Re RS, Morisky DE, Muntner P. New Medication Adherence Scale Versus Pharmacy Fill Rates in Seniors With Hypertension. Am J Manag Care 2009;15(1):59-66.
Morisky DE, DiMatteo MR. Improving the measurement of self-reported medication poor adherence: Final re-sponse. J ClinEpidemio 2011; 64:258-263. PMID:21144706
Sheilini M et al.Antihypertensive Treatment, Medication-Non-Adherence and Factors Leading toNon-Adherence Among Elderly Manipaluniversity,manipal
Kumar N et. al. Factors associated with adherence to an-tihypertensive treatment among patients attending a ter-tiary care hospital in Mangalore, South india
Khanam M A, Lindeboom W, Koehlmoos T L P, Alam D S, Niessen L and Milton A H Hypertension: adherence to treatment in rural Bangladesh findings from a popula-tion-based study in Bangladesh.
Hsu YH, Mao CL, Wey M. Antihypertensive Medication Adherence among Elderly Chinese Americans. J Trans-cultNurs 2010; 21(4):297- 305.
Ramli A, Ahmad NS, Paraidathathu T. Medication ad-herence among hypertensive patients of primary health clinics in Malaysia. Patient Prefer Adherence 2012 ; 6:613-22
Dessie A, Asres G, Meseret S, Birhanu Z Adherence to antihypertensive treatment and associated factors among patients on follow up at University of Gondar Hospital, Northwest Ethiopia. BMC Public Health 2012; 12:282.
Lowry KP, Dudley TK, Oddone EZ, Bosworth HB. Inten-tional and unintentional nonadherence to antihypertensive medication. Ann Pharmacother. 2005; 39(7-8):1198-203.
Lee GK, Wang HH, Liu KQ, Cheung Y, Morisky DE, Wong MC. Determinants of medication adherence to an-tihypertensive medications among a Chinese population using Morisky Medication Adherence Scale. PLoS One 2013; 8 (4): e62775. doi:10.1371/journal.pone.0062775
Patel RP, Taylor SD. Factors affecting medication adher-ence in hypertensive patients.AnnPharmacother 2002; 36 (1):40-5.
Atulomah NO, Florence MO, Oluwatosin A. Treatment adherence and risk of non-compliance among hyperten-sives at a Teaching Hospital in Ogun state, southwest Nigeria.acta SATECH 2010; 3(2):143- 149.
Chelkeba L, Dessie S. Antihypertension medication ad-herence and associated factors at Dessie Hospital, North East Ethiopia, Ethiopia. Int J Res Med Sci 2013;1(3):191-197.
Hashmi SK, Afridi MB, Abbas K, Sajwani RA, Saleheen D, Frossard PM et al.Factors associated with adherence to anti-hypertensive treatment in Pakistan. PLoS One. 2007 Mar 14;2 (3):e280.
Susan R, Anu K, Achu T, Soumya G, Vijayakumar K, Anish TS.Antihypertensive Drug Compliance across Clin-ic and Community Settings, in Thiruvananthapuram, South India.
Caro JJ, Salas M, Speckman JL, Raggio G, Jackson JD. Persistence with treatment for hypertension in actual practice. CMAJ. 1999;160(1): 31–37
Use of the ©MMAS is protected by US copyright laws. Per-mission for use is required. A license agreement is available from: Donald E. Morisky, ScD, ScM, MSPH, Professor, De-partment of Community Health Sciences, UCLA School of Public Health, 650 Charles E. Young Drive South, Los Ange-les, CA 90095-1772
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