Patient adherence to antihypertensive medications in upper Egypt: a cross-sectional study

Abstract

Background: Control of hypertension is a very difficult issue. Non-adherence to medications is a well-recognized factor contributing to uncontrolled hypertension. It is required to detect factors that affect adherence of patients to antihypertensive medications at different societies and good planning with the collaboration of governments, universities, media, pharmaceutical companies, and civil society to create intervention programs ensuring good adherence to medications. In our study, we aimed to determine different factors affecting adherence to antihypertensive medications in Upper Egypt societies. Results: From September 2015 to September 2019, we conducted a large cross-sectional multi-center study among 2420 hypertensive patients attending the outpatient cardiac clinics at three different university hospitals. Data was collected through a personal interview with the patients using a questionnaire to cover a variety of items. In the total of 2420 patients, we found that 1116 (46.12%) patients were adherent to medications and 1304 (53.88%) were non-adherent. From the final regression analysis of the results, we found that age > 65 years, illiterate patients, low income, associated comorbidities, using three or more antihypertensive pills, and living in rural areas were statistically significant socio-demographic factors associated with non-adherence to treatment. Also, missing doses of medication and lack of complying with dietary regimen were statistically significant behavioral causes associated with non-adherence. Conclusion: Many factors are predictors of good adherence to antihypertensive drugs, including young age, urban residence, a smaller number of pills, absence of comorbid conditions, high income, and high education level. Also missed doses of drugs and absence of complies with dietary regimen were the significant causes of nonadherence. Health institutions and governmental efforts should be directed toward improving adherence by creating effective intervention programs targeting these factors. Therefore, it might be concluded that patients who are more health ware are more adherent to medications than non-health aware patients.

Self-Care Practice and Associated Factors among Hypertensive Patients in Ethiopia: A Systematic Review and Meta-Analysis

“…However, this finding is lower than a study reported from America in 2015 (69%) [ 63 ] and Korea (81.7%) [ 64 ]. In contrast, this finding is higher than a study reported from Egypt (46.12%) [ 65 ] and Palestine (45.8%) [ 66 ]. The discrepancy might be due to differences in the socioeconomic status of participants.…”

Patient and healthcare provider perspectives on adherence with antihypertensive medications: an exploratory qualitative study in Tanzania

“…Our study also showed that physicians felt that fear of side effects from long term medication use contributed to patient non-adherence to antihypertensive medications. Age, gender, place of residence, income, educational levels, number of prescriptions, price of medications, comorbidities, adverse effects, and not feeling the need for regular use have shown to be predictors of adherence to antihypertensive medications in studies conducted in Egypt, Pakistan, and Bangladesh [ 17 , 18 , 45 ]. Travel costs, long wait times, clinic operating hours, inadequate patient knowledge, and under-dispensing of medications were shown to be other limiting factors in a study in Nigeria [ 34 ], which were also mentioned by participants in our study.…”

“…Travel costs, long wait times, clinic operating hours, inadequate patient knowledge, and under-dispensing of medications were shown to be other limiting factors in a study in Nigeria [ 34 ], which were also mentioned by participants in our study. Predictors of antihypertensive medication include age, gender, place of residence, income, educational levels, number of prescriptions, price of medications, comorbidities, adverse effects, and not feeling the need for regular use [ 17 , 18 , 45 ].…”

“…Inequities in patient access and affordability appear to be major contributors to poor adherence [ 16 ]. Other patient level factors that have shown to be strong predictors of adherence to antihypertensive medications include age, place of residence, income, educational levels, number of prescriptions, free medications, and comorbidities [ 17 , 18 ]. Barriers to optimal patient compliance include inadequate knowledge of medication importance, perceived threat of the disease, and prioritization of other life events [ 19 ].…”

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

“…Barriers of not complying with antihypertensive medication were determined. The reasons were; stopping medication due to cost of the medications 20 , 34 , fear of the side effect 35 , 36 , feeling well (asymptomatic) 37 , avoiding addiction to drugs 38 , 39 and use of traditional medicine. 28 …”