Compliance and its determinants to pharmacologic management of hypertension

Authors

  • Jincy Johnson Dr. Somervell Memorial CSI Medical College, Karakonam, Trivandrum, 695011, Kerala, India
  • Krishnapillai Vijayakumar Amrita Institute of Medical Sciences and Research Centre, Ernakulam, 682041, Kerala, India
  • Zinia Thajudeen Nujum Government Medical College, Parippally, Kollam
  • Prathibha Madhavanpillai Thankamoniamma Travancore Medical College Hospital, Kollam, 691589, Kerala, India

DOI:

https://doi.org/10.47203/IJCH.2019.v31i01.011

Keywords:

Hypertension, Blood Pressure, Compliance, Cross sectional study, Antihypertensive Agents, Self Report

Abstract

Background: Compliance to medications and lifestyle modifications is important in the management of hypertension. Aims and Objectives: The purpose of this study was to measure the compliance and its determinants to pharmacological management of hypertension. Material & Methods: A population based cross sectional survey was conducted among 221 known hypertensives in medical college health unit area of urban Trivandrum. Results: Mean age of the study subjects was 64.6 yrs (SD 10.6). The overall compliance with antihypertensives was 62.4%. Male gender, joint/extended family type, family support, co-morbidities, once daily regimen, awareness about the BP control status and adequacy of BP control were the predictors of good compliance. The barriers to compliance were alcohol abuse, out of pocket expenditure and more number of pills/day. Conclusion: Drug compliance among the study population was low compared to previous studies. Low drug compliance and poor blood pressure control among the hypertensives in the area warrants immediate actions to prevent the development of complications. The burden of morbidity and mortality due to hypertension and related complications on the family and health system will be immense if the situation is left unattended.

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Author Biographies

Zinia Thajudeen Nujum, Government Medical College, Parippally, Kollam

Associate Professor, Department of Community Medicine, Government Medical College, Kollam, Kerala, India

Prathibha Madhavanpillai Thankamoniamma, Travancore Medical College Hospital, Kollam, 691589, Kerala, India

Assistant Professor, Travancore Medical College Hospital, Kollam, Kerala, India

References

Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005 Jan 15-21;365(9455):217-23. PubMed PMID: 15652604.[PubMed].

Thankappan KR, Sivasankaran S, Sarma PS, Mini G, Khader SA, Padmanabhan P, Vasan R. Prevalence-correlates-awareness-treatment and control of hypertension in kumarakom, kerala: baseline results of a community-based intervention program. Indian Heart J. 2006 Jan-Feb;58(1):28-33. PubMed PMID: 18984927.[PubMed].

Kalavathy MC, Thankappan KR, Sarma PS, Vasan RS. Prevalence, awareness, treatment, and control of hypertension in an elderly community-based sample in Kerala, India. Natl Med J India 2000;13(1):9–15.

Granger BB, Swedberg K, Ekman I, Granger CB, Olofsson B, McMurray JJ, Yusuf S, Michelson EL, Pfeffer MA; CHARM investigators.. Adherence to candesartan and placebo and outcomes in chronic heart failure in the CHARM programme: double-blind, randomised, controlled clinical trial. Lancet. 2005 Dec 10;366(9502):2005-11. PubMed PMID: 16338449.[PubMed].

Ho PM, Spertus JA, Masoudi FA, Reid KJ, Peterson ED, Magid DJ, Krumholz HM, Rumsfeld JS. Impact of medication therapy discontinuation on mortality after myocardial infarction. Arch Intern Med. 2006 Sep 25;166(17):1842-7. PubMed PMID: 17000940.[PubMed].

Hawkshead J, Krousel-Wood MA. Techniques for measuring medication adherence in hypertensive patients in outpatient settings. Advantages and limitations. Dis Manag Heal Outcomes. 2007;15(2):109–18.

Krousel-Wood M, Thomas S, Muntner P, Morisky D. Medication adherence: a key factor in achieving blood pressure control and good clinical outcomes in hypertensive patients. Curr Opin Cardiol. 2004;19(4):357–62.

Burnier M. Medication adherence and persistence as the cornerstone of effective antihypertensive therapy. Am J Hypertens. 2006 Nov;19(11):1190-6. Review. PubMed PMID: 17070434.[PubMed].

Adherence to long term therapies - Evidence for action.

Available at https://www.who.int/chp/knowledge/publications/adherence_report/en/. Accessed June 12th, 2014

Kish Summary of Eight Tables. Available at: http://www.who.int/chp/steps/resources/Kish_Summary_of_Eight_Tables.doc. Accessed November 26th , 2012

Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005 Aug 4;353(5):487-97. Review. PubMed PMID: 16079372.[PubMed].

Inkster ME, Donnan PT, MacDonald TM, Sullivan FM, Fahey T. Adherence to antihypertensive medication and association with patient and practice factors. J Hum Hypertens. 2006 Apr;20(4):295-7. PubMed PMID: 16424861.[PubMed].

Hashmi SK, Afridi MB, Abbas K, Sajwani RA, Saleheen D, Frossard PM, Ishaq M, Ambreen A, Ahmad U. Factors associated with adherence to anti-hypertensive treatment in Pakistan. PLoS One. 2007 Mar 14;2(3):e280. PubMed PMID: 17356691; PubMed Central PMCID: PMC1805684.[PubMed].

Susan R, Anu K, Achu T, Soumya G, Vijayakumar K, Anish TS. Antihypertensive drug compliance across clinic and community settings, in Thiruvananthapuram, South India. Health Sci Open Access Peer Rev E-J 2012;1(3).

Bhandari S, Sarma PS, Thankappan KR. Adherence to Antihypertensive Treatment and Its Determinants Among Urban Slum Dwellers in Kolkata, India. Asia Pac J Public Health. 2015 Mar;27(2):NP74-84.

Rao CR, Kamath VG, Shetty A, Kamath A. Treatment Compliance among Patients with Hypertension and Type 2 Diabetes Mellitus in a Coastal Population of Southern India. Int J Prev Med. 2014 Aug;5(8):992-8. PubMed PMID: 25489447; PubMed Central PMCID: PMC4258676.[PubMed].

Venkatachalam J, Abrahm S, Singh Z, Stalin P, Sathya G. Determinants of patient?s adherence to hypertension medications in a rural population of Kancheepuram District in Tamil Nadu, South India. Indian J Community Med. 2015;40(1):33.

Hema K, Padmalatha P. Original article: Adherence to medication among hypertensive patients attending a tertiary care hospital in Guntur, Andhra Pradesh. Indian J Basic Appl Med Res. 2014;4(1):451–6.

Jacqueline M. Klootwyk, Cynthia A. Sanoski. Medication Adherence and Persistence in Hypertension Management. J Clin Outcomes Manag 18(8):351–8.

Muhammad Umair Khan, Shahjahan Shah, Tahir Hameed. Barriers to and determinants of medication adherence among hypertensive patients attended National Health Service Hospital, Sunderland. J Pharm Bioallied Sci 2014;6(2):104.

Grigoryan L, Pavlik VN, Hyman DJ. Predictors of antihypertensive medication adherence in two urban health-care systems. Am J Hypertens. 2012 Jul;25(7):735-8. doi: 10.1038/ajh.2012.30. Epub 2012 Mar 22. PubMed PMID: 22441507.[PubMed].

Wang PS, Bohn RL, Knight E, Glynn RJ, Mogun H, Avorn J. Noncompliance with antihypertensive medications: the impact of depressive symptoms and psychosocial factors. J Gen Intern Med. 2002 Jul;17(7):504-11. PubMed PMID: 12133140; PubMed Central PMCID: PMC1495082.[PubMed].

Cené CW, Dennison CR, Powell Hammond W, Levine D, Bone LR, Hill MN. Antihypertensive medication nonadherence in black men: direct and mediating effects of depressive symptoms, psychosocial stressors, and substance use. J Clin Hypertens (Greenwich). 2012;15(3):201-9.

George J. Fodor, Marian Kotrec, Kinga Bacskai, Thomas Dorner, Jan Lietava, Sandor Sonkodi, et al. Is interview a reliable method to verify the compliance with antihypertensive therapy? An international central-European study. J Hypertens 2005;23(6):1261–6.

Zeller A, Schroeder K, Peters T. Cigarette smoking and adherence to antihypertensive medication in patients from primary care. Eur J Gen Pract. 2007;13(3):161-2. PubMed PMID: 17853178.[PubMed].

Manal Ibrahim Hanafi Mahmoud (last). Compliance with treatment of patients with hypertension in Almadinah Almunawwarah: A community-based study. J Taibah Univ Med Sci 2012;7(2):92–8.

Wong MCS, Liu J, Zhou S, Li S, Su X, Wang HHX, et al. The association between multimorbidity and poor adherence with cardiovascular medications. Int J Cardiol 2014;177(2):477–82.

Tilea I, Petra D, Voidazan S, Ardeleanu E, Varga A. Treatment adherence among adult hypertensive patients: a cross-sectional retrospective study in primary care in Romania. Patient preference and adherence. 2018; 12:625-635.

Bangalore S, Kamalakkannan G, Parkar S, Messerli FH. Fixed-dose combinations improve medication compliance: a meta-analysis. Am J Med. 2007 Aug;120(8):713-9. PubMed PMID: 17679131.[PubMed].

M. Kabir ZI, I. S. Abubakar MJ. Compliance to medication among hypertensive patients in Murtala Mohammed Specialist Hospital, Kano, Nigeria. J Community Med Prim Health Care. 2004;16(1):16–20.

Leenen FH, Wilson TW, Bolli P, Larochelle P, Myers M, Handa SP, Boileau G, Tanner J. Patterns of compliance with once versus twice daily antihypertensive drug therapy in primary care: a randomized clinical trial using electronic monitoring. Can J Cardiol. 1997 Oct;13(10):914-20. Review. PubMed PMID: 9374947.[PubMed].

Balazovjech I, Hnilica P. Compliance with antihypertensive treatment in consultation rooms for hypertensive patients. J Hum Hypertens. 1993;7:581–3

Ohene Buabeng K, Matowe L, Plange-Rhule J. Unaffordable drug prices: the major cause of non-compliance with hypertension medication in Ghana. J Pharm Pharm Sci. 2004 Nov 12;7(3):350-2. PubMed PMID: 15576016.[PubMed].

Munger MA, Van Tassell BW, LaFleur J. Medication nonadherence: an unrecognized cardiovascular risk factor. MedGenMed. 2007 Sep 19;9(3):58. Review. PubMed PMID: 18092064; PubMed Central PMCID: PMC2100116.[PubMed].

Joshi PP, Salkar RG, Heller RF. Determinants of poor blood pressure control in urban hypertensives of central India. J Hum Hypertens. 1996 May;10(5):299-303. PubMed PMID: 8817403.[PubMed]

Anchala R, Kannuri NK, Pant H, et al. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. Journal of Hypertension.2014;32(6):1170-1177.

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Published

2019-03-31

How to Cite

1.
Johnson J, Vijayakumar K, Nujum ZT, Thankamoniamma PM. Compliance and its determinants to pharmacologic management of hypertension. Indian J Community Health [Internet]. 2019 Mar. 31 [cited 2024 Apr. 27];31(1):63-72. Available from: https://iapsmupuk.org/journal/index.php/IJCH/article/view/1015

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