Adherence to hypertension medication: Quantitative and qualitative investigations in a rural Northern Vietnamese community

Abstract

ObjectivesThe purposes of this study were to assess the adherence to medication of hypertensive patients visiting community health stations in a rural area in Vietnam, to examine the relationship between levels of adherence and cardiovascular risk among hypertensive patients and to further understand factors influencing adherence.MethodsThis study is part of a prospective one-year study conducted on hypertension management in a population aged 35 to 64 years. Data on age, sex, blood pressure and blood test results were collected at baseline. Cardiovascular risk was based on the Cardiovascular Risk Prediction Model for populations in Asia. To calculate medication adherence, the number of days the drug was taken was divided by the number of days since the first day of the prescription. A threshold of 80% was applied to differentiate between adherence and non-adherence. In-depth interviews were conducted among 18 subjects, including subjects classified as adherent and as non-adherent.ResultsAmong 315 patients analyzed, 49.8% of the patients were adherent. Qualitative investigation revealed discrepancies in classification of adherence and non-adherence based on quantitative analysis and interviews. No significant difference in medication compliance between two cardiovascular disease risk groups (<10% vs. >10% risk) was found, also not after controlling for age, sex, and ethnicity (adjusted odds ratio at 1.068; 95% CI: 0.614 to 1.857). The odds of medication adherence in females was 1.531 times higher than in males but the difference was not statistically significant (95% CI: 0.957 to 2.448). Each one-year increase in age resulted in patients being 1.036 times more likely to be compliant (95% CI: 1.002 to 1.072). Awareness of complications related to hypertension was given as the main reason for adherence to therapy.ConclusionsMedication adherence rate was relatively low among hypertensive subjects. The data suggest that rather than risk profile, the factor of age should be considered for guiding the choice on who to target for improving medication adherence.

Prevalence, Awareness, Treatment, and Control of Hypertension and Its Risk Factors in (Central) Vietnam

“…Previously, poor access to medical facilities combined with limited availability of adequate treatment was shown to be correlated with hypertension in Vietnam and Southeast-Asian population. In addition to the population's lack of knowledge about hypertension, the relationship between physicians and patients, the adherence to medication, and health system characteristics were suggested to play an important role in the attitude of the population to the disease [22–24]. …”

Evaluation of antihypertensive adherence and its determinants at primary healthcare facilities in rural South Africa

“…The questionnaire also collected information on factors that previously have been shown to be associated with adherence. These included gender, education, level of BP control, comorbidities, family history, knowledge of hypertension management, physical activity and smoking, in line with previous studies [1,12,14,36,49]. With the exception of vital signs, such as BP and body mass index (BMI), all the information was received from self-reporting.…”

“…Non-pharmacological treatments include reducing salt intake, improving diets and increasing exercise levels [12,13,34]. Adherence to chronic medication results in better healthcare outcomes for patients, in this case better BP control [12,14,33,36].…”

Medication adherence among hypertensive adults residing in a rural area of Dakshina Kannada district

“…19 In a study carried out in northern Vietnamese community, adherence seemed to be influenced by age, as older patients used their medication more often in accordance with the doctor's advice. 20 Our study has certain limitations. The associations observed in this study may not imply causality, as it is a cross-sectional assessment.…”