Barriers to and determinants of medication adherence among hypertensive patients attended National Health Service Hospital, Sunderland

Khan, Muhammad Umair; Shah, Shahjahan; Hameed, Tahir

doi:10.4103/0975-7406.129175

Cited by 66 publications

(57 citation statements)

References 29 publications

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“…The finding is lower than the studies conducted in Maritime Canada (77.0% [26], Pakistan(77.0%) [27], Singapore (75.2%) [28] and in Sunderland (79%) [29]. This difference could be due to difference in socio-demographic characteristics and health care facilities among this study and the comparison studies.…”

Section: Discussioncontrasting

confidence: 78%

Drug adherence for antihypertensive medications and its determinants among adult hypertensive patients attending in chronic clinics of referral hospitals in Northwest Ethiopia

Mekonnen

Gebrie

Eyasu

et al. 2017

BMC Pharmacol Toxicol

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BackgroundAdherence to prescribed medication is an imperative issue which can be directly linked with the management of chronic diseases like hypertension; failure to adhere can affect the effectiveness of medication as well as the efficiency of the health care system. There is scarcity of information regarding the level of drug adherence for antihypertensive medications and its determinants in Ethiopia, particularly in the study area. Therefore, the aim of this study was to assess adherence level and its determinants for antihypertensive medications among adult hypertensive patients attending the chronic illness clinics of the referral hospitals in northwest Ethiopia.MethodsInstitution based cross sectional study was conducted from March to April, 2016. The systematic random sampling technique was used to select 409 study participants from three referral hospitals. The questionnaire was prepared using the World Health Organization (WHO) conceptual model and by reviewing international literature. The data were collected using an interviewer administered questionnaire. The data were entered in to Epi - Info version 7 and then transferred to the statistical package for social science (SPSS) version 20 for data cleaning and analysis.Bivariate analysis was first done to see the association between each independent variables and dependent variable. Variables with a P-value of less than 0.2 in the bivariate analysis were entered in to the multivariate logistic regression model for final analysis. Multivariate analysis was done using Backward logistic regression method. P-value less than 0.05 was considered to determine the statistical significance of the association and odds ratio with a 95% confidence interval was used to determine the presence, strength, and direction of association between covariates (explanatory variables) and the outcome variable. The Morisky medication adherence scale was used to assess the adherence status using > = 6 as adherent or < 6 as non adherent score.ResultsFour hundred and nine (409) study participants were interviewed with a response rate of 100%. The mean age of the respondents was 54.5 years with (Standard Deviation (SD) ± 13.58). The overall rate of good adherence was 67.2% (95% CI = 62.8, 71.6). Participants who had a favourable attitude towards antihypertensive medications (Adjusted odds ratio (AOR) = 9.88, 95% confidence interval (CI): 5.34, 18.27), having good patient- provider relationship (AOR = 4.25, 95% CI: 2.32, 7.86), having one (AOR = 4.36, 95% CI: 1.34, 14.12) or no (AOR = 3.38, 95% CI:1.01,11.31) co-morbidities, a long duration of treatment (AOR = 1.89, 95%CI: 1.07, 3.35), and a low medical cost (AOR = 2.06, 95% CI: 1.13, 3.76) had associations with good drug adherence for antihypertensive medication/s.ConclusionsThe prevalence of good drug adherence for anti-hypertensive medications in this study was high. Prevention of co- morbidities, making medical services accessible, and maintaining good client-provider interaction are of paramount importance for good drug adherence.

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Section: Discussioncontrasting

confidence: 78%

Drug adherence for antihypertensive medications and its determinants among adult hypertensive patients attending in chronic clinics of referral hospitals in Northwest Ethiopia

Mekonnen

Gebrie

Eyasu

et al. 2017

BMC Pharmacol Toxicol

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“…13 Three other studies at Sunder lands, Ethiopia and Pakistan showed better adherence rates of 79% ,64.6% and 77% respectively. [18][19][20] Another study in South India with 516 patients, prevalence of poor adherence to hypertension medications was 25.58% which was higher when compared to present study (18.7%). 10 Those were conducted at hospital settings unlike our study which was in a community setting.…”

Section: Discussioncontrasting

confidence: 51%

Prescription to practice in hypertension: a community experience in central Kerala

et al. 2017

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Background: Control of blood pressure is a global challenge and non-adherence to hypertension medications is a public health concern. Patient, medication and system related factors can contribute to non-adherence. The study was to determine adherence to hypertension medications and to understand the barriers to adherence in an adult group in Pathanamthitta District of Central Kerala.Methods: A cross sectional study was conducted in a community setting in 2016, among 139 adults aged 30 years and above on treatment for hypertension for at least six months. Those with gestational hypertension, those having serious comorbid conditions and those unwilling to participate were excluded. The data sheet included basic demographic information and history related to hypertension. A content validated eight item questionnaire was used to assess reported adherence and scores classified level of adherence as good (8), moderate (6-<8) and poor (<6). The data was analyzed using SPSS. Chi square test of significance and multivariate regression analysis were done. P<0.05 was considered statistically significant.Results: The participants were in the age group 34-91 years, 50.4% belonging to 50-69 years, and 75.5% were females. Adherence to hypertension medications was good in 49.6%, moderate in 31.7% and poor in 18.7%. The most common factors reported to contribute to non-adherence were forgetfulness (70.5%), high cost of medications (51.8%), and symptom-free state (27.3%).Conclusions: Adherence was good in less than half the study participants and poor in almost one-fifth. Forgetfulness and high medication costs were the most commonly reported barriers. These findings highlight the importance of individuals, families and health service, joining hands to tackle the public health problem of non-adherence to hypertension medications.

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“…23 Compliance from study using Morisky Medication adherence Scale in a study in Sunderland was found to be 79%. 24 A slightly lower level of compliance (55.5%) was reported in a study in Ethiopia using the MMAS-8 scale. 25 Ajayi et al reported a prevalence of 44.7% from a study in Nigeria using MMAS-4 scale for measuring adherence.…”

Section: Discussionmentioning

confidence: 99%

Compliance to antihypertensive medication: a cross-sectional study in Aligarh

Khwaja

Ansari

Mehnaz

2017

Int J Community Med Public Health

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Background: Hypertension is a global public health issue. Hypertensive heart disease is one of the top ten leading causes of death in the world. It was responsible for an estimated 1.1 million deaths worldwide in 2012. To prevent some of the complications of hypertension regular intake of the prescribed treatment in the form of medicines (pills) is essential. Poor compliance to anti-hypertensive therapy is usually associated with bad outcome of the disease and wastage of limited health care resources. With these viewpoints the study aimed to assess the level of compliance of hypertensive patients to their anti-hypertensive medications and to determine the socio-demographic correlates of compliance. Methods: This was community based cross sectional study conducted in urban and rural areas in Aligarh. A total of 350 hypertensive patients were selected using simple random sampling. A pretested semi-structured questionnaire was used. Compliance was measured by Morisky 8-item Medication Adherence scale. Analysis was done using proportions and Chi-square test. Results: The overall compliance of study population was 23.7%. It was found to be significantly associated with gender, education, social class and associated co morbidities. Education, higher social class and duration of hypertension were found to be the main facilitators to adherence. The barriers to adherence were cost of drug and more number of pills per day. Conclusions: Patient education, family counselling and social support networks should be strengthened in health promotion programs in order to enhance compliance of hypertensive patients with the therapeutic regimen and to improve their quality of life.

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Barriers to and determinants of medication adherence among hypertensive patients attended National Health Service Hospital, Sunderland

Cited by 66 publications

References 29 publications

Drug adherence for antihypertensive medications and its determinants among adult hypertensive patients attending in chronic clinics of referral hospitals in Northwest Ethiopia

Drug adherence for antihypertensive medications and its determinants among adult hypertensive patients attending in chronic clinics of referral hospitals in Northwest Ethiopia

Prescription to practice in hypertension: a community experience in central Kerala

Compliance to antihypertensive medication: a cross-sectional study in Aligarh

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