Compliance or non-compliance of hypertensive adults to hypertension management at three primary healthcare day clinics in Tshwane

Abstract

The objective of this article was to report on the rate of compliance to medication, sodium use and appointment keeping of hypertensive adults who are attending primary healthcare clinics in Tshwane. Despite the availability of effective management of hypertension globally, non-compliance to management still exists. This article reports on the hypertensive adult's compliance to medication, sodium use and appointment keeping. The design was a crosssectional descriptive study. The sample was n = 101 hypertensive patients from three primary healthcare clinics. Structured interviews were used to gather the data. The results indicated a variation in compliance rate depending on the question asked. When investigating whether the participants received enough medication on their last visit to the clinic, 98% said that they received enough medication to last them a month (Nkosi 2008:130). However, the appointment-keeping scale revealed that 23% of the participants reported that they left the clinic without prescribed medication or missed an appointment. When, using the Hill-Bone Compliance Scale, individuals were asked a question using the verb forgetting, 9 out of 10 would answer 'no', but when the verb decide was used to determine compliance, 6 out of 10 would admit to deciding not to take their medication sometimes. In terms of sodium use, 33% showed good compliance and 44% low compliance (Nkosi 2008:138). Compliance with regard to taking hypertension medication was 70%, which is good. This study recommends that compliance to hypertension management be assessed by asking questions specifically for sodium use, medication and appointment keeping as it was clear from the findings of this study that a person would comply with appointment keeping but not take medication daily as prescribed or not use sodium as recommended.

Treatment adherence among patients with hypertension: findings from a cross-sectional study

“…In another study done in the United States, female patients were less adherent to hypertension medication compared to male patients [13]. A study conducted in Malaysia reported that female patients were more adherent than male patients [22]. Our study showed that there was no significant relationship between gender and adherence.…”

Assessing Adherence to Antihypertensive Therapy in Primary Health Care in Namibia: Findings and Implications

“…In this study, no patient had perfect adherence to antihypertensive therapy, and over half (58%) of the patients had adherence levels less than the designated threshold of 80% [ 6 , 26 , 30 ]. This is lower than studies in South Africa and Zambia [ 22 , 35 ], but comparable to other countries including Kenya and Korea [ 13 , 36 – 38 ]. Any differences may be due to the different study and culture settings, patient characteristics, as well as sub-scales of the Hill-Bone scale used to assess compliance.…”

Assessment of medication adherence among hypertensive patients: a cross-sectional study

“…Several studies using different research instrument and systematic reviews have also addressed issues of poor medication adherence/compliance among hypertensive patients. 16,20,23,[29][30][31] In this study, we identified that hypertensive patients often forgot to take their medications, often forgot to get their prescription refilled, usually ran out of hypertensive pills and often missed their hypertension pills when careless or when they fell sick, thus contributing to lower medication adherence. Our findings are comparable to study conducted by Song et al using hill bone medication adherence in Korean Americans, where they documented poor medication adherence and identified issues of non-adherence in which majority hypertensive patients often forgot to take their medications and often missed their hypertension pills when they felt sick.…”

“…27 Similarly Mafutha et al using hill bone medication adherence documented that medication compliance was good but identified non adherence issues in hypertensive patients in which they often decided not to take their hypertension medicine and often ran out of hypertension medicines. 29 A study conducted by Ramli et al with medication adherence Scale (modified of HILL-BONE CHBPTS and Morisky medication adherence scale) documented higher proportion of non-adherence. They also addressed nonadherence issues of forgetting, missing and running out of hypertension medications.…”

“…This supports the result of various studies that uncontrolled BP occurred in the higher percentage in non-adherent patients compared to adherent group. 29,43,44 Non-compliance to sodium usage is real and happening in patients with chronic diseases. Bland food due to low salt content does not taste good, which makes it difficult to adhere to a diet low in sodium.…”