Prevalence and determinants of medications non-adherence among patients with uncontrolled hypertension in primary care setting in Sarawak, Malaysia: A cross-sectional study

Abstract

Introduction: Non-adherence to antihypertensive medications is a leading cause of uncontrolled hypertension and its complications. However, data on the factors associated with non-adherence to antihypertensive medications in the communities of Sarawak, Malaysia, are limited. This study aimed to examine the prevalence and determinants of medication non-adherence among patients with uncontrolled hypertension. Methods: A cross-sectional study was conducted using the systematic sampling method in four government primary healthcare clinics in Sarawak. A self-administered questionnaire was used to obtain socio-demographic data and evaluate non-adherence. Blood pressure was measured, and relevant clinical variables were collected from medical records. Multivariate logistic regression was used to determine the determinants of medication non-adherence. Results: A total of 488 patients with uncontrolled hypertension were enrolled in this study. The prevalence of medication non-adherence was 39.3%. There were four predictors of medication non-adherence among the patients with uncontrolled hypertension: tertiary educational level (odds ratio [OR]=4.21, 95% confidence interval [CI]=1.67–10.61, P=0.010), complementary alternative medication (OR=2.03, 95% CI=1.12–3.69, P=0.020), non-usage of calcium channel blockers (OR=1.57, 95% CI=1.02–2.41, P=0.039) and 1 mmHg increase in the systolic blood pressure (OR=1.03, 95% CI=1.00–1.05, P=0.006). Conclusion: Because of the high prevalence of medication non-adherence among patients with uncontrolled hypertension, primary care physicians should be more vigilant in identifying those at risk of being non-adherent. Early intervention should be conducted to address non-adherence for blood pressure control.

Domains of Adherence and Non-Adherence to Anti-Hypertensive Medications in Hypertensive Patients from Kuala Lumpur: A Qualitative Study

“…They were only able to recognise the medication by the appearance of the packet or label. The findings of the present study are in agreement with previous hypertension studies whereby the lack of knowledge about the illness (21), complication (22), and medication (23) are associated to non-adherence. Given the importance of patients' education in improving medication adherence, healthcare providers should, therefore, empower their patients via the provision of education regarding the illness and medications.…”

Factors associated with non-adherence to angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in older patients with peripheral arterial disease

“…These results indicate favourable association of beta-blockers and calcium channel blockers with both implementation and persistence phases of adherence. In line with our findings, in a cross-sectional study by Thew et al (2022) , non-usage of calcium channel blockers represented one of four factors associated with non-adherence among patients with uncontrolled hypertension.…”