Factors Affecting Adherence to Antihypertensive Medication

Abstract

BackgroundHypertension is a major contributor to the global disease burden of cardiovascular and cerebrovascular disease. The aim of this study was to determine demographic and clinical factors associated with adherence to antihypertensive medication.MethodsFrom August 2012 to February 2015, we recruited 1,523 Korean patients with hypertension who visited family physicians. The study was conducted in 24 facilities located in urban and metropolitan areas. Of these facilities, two were primary care clinics and 22 were level 2 or 3 hospitals. Adherence was assessed using the pill count method; a cut-off value of 80% was used as the criterion for good adherence. Sociodemographic and lifestyle factors were compared between the adherent and nonadherent groups using the chi-square test for categorical variables and t-test for continuous variables. Binary logistic regression analysis was performed with medication adherence as the outcome variable.ResultsOf the 1,523 patients, 1,245 (81.7%) showed good adherence to antihypertensive medication. In the multivariate logistic analysis, age ≥65 years, exercise, treatment in a metropolitan-located hospital, being on ≥2 classes of antihypertensive medication and concomitant medication for diabetes, and a family history of hypertension or cardiovascular diseases were associated with good adherence. Patients who had a habit of high salt intake were less adherent to medication.ConclusionMultiple classes of antihypertensive medications, concomitant medication, and exercise were associated with good adherence to antihypertensive medication, and high salt intake was associated with poor adherence to antihypertensive medication. These factors should be considered to improve hypertension control.

Using the Health Believe Model to Explain the Patient’s Compliance to Anti-hypertensive Treatment in Three District Hospitals - Dar Es Salaam, Tanzania: A Cross Section Study

“…The current study shows that, participants who were 64 and below years of age had higher level of treatment compliance compared to those with 65 and above years of age. These results are comparable to those reported from the study done in North America and Korea, reported older age showed association with treatment compliance [19,20]. The possible explanation of these results might be the truth that, the young people have higher income since they are able to work and thus can afford to buy medications than older people.…”

“…Our findings showed compliance was higher than that of study conducted in Mumbai, reported 39.4% were compliant to their treatment [17]. The compliance was lower than that reported to the previous study in Korea and India [18,19]. The possible reason for the discrepancy observed could be explained by the types of hospitals included in our study, we included district hospitals, where participants attended are average Tanzanian compared to participants enrolled in the study conducted at Korea and India whom were from tertial hospitals with higher income and education, this could account for the difference observed.…”

“…Distribution of participants by reasons of not complying with antihypertensive medication were determined, the reasons were stopping medication due to; cost of the medications, fear of the side effect [19,20], feeling well (asymptomatic), avoiding addiction of drugs [18] and use of traditional medicine [21].…”

Determining the Prevalence of and the Factors Associated with Antihypertensive Medication Non-Adherence in the Gaza Strip

“…These significant predictors included the following: age (OR, 1.04; derstanding about the complications of A-HTNM, lack of social support, poor physician-patient relationship, and health care support affect adherence in different populations. 5,7,[23][24][25] Addressing these factors is very important for successful control and management of HTN. To the best of our knowledge, this is the first study to investigate adherence to A-HTNM and its associated factors among HTN patients attending primary health care centers in the Gaza Strip.…”

“…However, this finding is consistent with those of several other studies. 13,23,24) One reason for this finding could be that patients taking two or more pills recognize the severity of their disease and hence become more attentive to their treatment. In addition, taking multiple pills probably helped them avoid forgetting their medications.…”