A community-based study to assess the treatment adherence and its determinants among hypertensive patients residing in a rural area of Kancheepuram district, Tamil Nadu

Abstract

the health-care delivery system in India. [1,2] Hypertension has been identified as the direct cause of deaths in more than 55% and 25% of all stroke and all coronary heart disease-related deaths reported in India.[3] Even on a global scale, hypertension is one of the most important causes of premature death as per the World Health Organization. [4] Current estimates reveal that hypertension affects more than 30% of adults with age 25 years and above which accounts for almost 1 billion people worldwide.[5] Furthermore, as per trend analysis, it has been estimated that more than 20 million cardiovascular deaths will be attributed to hypertension, by the year 2030, of which in excess of four-fifths will be from Background: Hypertension exerts a massive public health burden on cardiovascular health and health system in India. Objectives: The aim of this study is to assess the level of treatment adherence among the known hypertensive patients in a rural community and identify the determinants for non-adherence to treatment among them. Materials and Methods: A communitybased cross-sectional descriptive study was conducted for 2 months in Sembakkam and Kottamedu villages under the rural field practice area of a medical college among known cases of hypertension diagnosed and initiated on antihypertensive therapy at least 3 months back. A total of 170 hypertensive patients were included as study participants using random sampling, and the desired information was obtained using a semi-structured schedule, and details about treatment adherence based on the Morisky Medication Adherence Scale. Ethical clearance was obtained from the Institutional Ethics Committee before the start of the study. Written informed consent was obtained from the study participants before eliciting any information from them. Statistical analysis was done using SPSS version 18. Frequency distributions were calculated for all the variables. Chi-square test was used for testing the significance of association at P = 0.05. Results: Among the study participants, 81 (47.6%) had good medication adherence, whereas 89 (52.4%) had poor adherence. A statistically significant association was observed between indulging in regular physical activity and use of salt-restricted diet and a good level of treatment adherence. Poor adherence to treatment was found more commonly among patients who were prescribed multiple antihypertensive drugs and those with more than once daily dose formulation. Conclusion: The study indicates that prevalence of treatment adherence among hypertensive patients in rural areas of Tamil Nadu was only 47.6% and there is a lot of scope for improvement. The study has also identified the crucial factors responsible for non-compliance to antihypertensive treatment which can assist the health-care policy makers to formulate a comprehensive strategy to achieve adequate compliance.

Effect of Patient Counselling Based Intervention in Hypertensive Outpatients

“…of patients were in the age group of 50-59. The findings were similar with the data reported by Sunita Parma et al 4 Prevalence of non-adherence among hypertensive patient was found to be 54% in a study conducted by Arjun Balasubramanian et al 19 Similarly a study conducted at a healthcare facility in north India by Siraj Ahmad et al 20 showed prevalence of non-adherence among hypertensive patient to be 42.8%. Study conducted by Prateek et al 21 have reported non-adherence to be 87% among hypertensive patients in rural area of Tamil Nadu.…”

Adherence to Medications in Chronic Kidney Disease: Prevalence, Predictors and Outcomes

“…Prescription of ≥ 4-5 pills/day has been significantly associated with non-adherence in CKD patients. 13,24,25 Although difficult, few measures to minimise non-adherence could be to prescribe cheaper generic medicines, reduce the amount and frequency of drugs, prescribing the drug combinations for hypertension, DM and anemia, giving priority to long-acting formulations, use of long-acting insulin when indicated, judicious use of antibiotics, multivitamins and PPIs/H2 blockers.…”

Prevalence, Risk Factors, Control and Treatment Adherence of Hypertension: A Community-Based Study In An Egyptian Village

“…The final score described the adherence levels; a perfect eight meant high adherence, a score from seven to six meant medium adherence and, finally, a score less than six meant low adherence. 17 Furthermore, only patients with high adherence scores were considered adherent and those with low and medium adherence scores were considered non-adherent. Anthropometric measurements of weight and height were taken.…”