<p>Perceived Illness and Treatment Adherence to Hypertension Among Patients Attending a Tertiary Hospital in Kathmandu, Nepal</p>

Abstract

Introduction: Hypertension (HTN) is a silent killer, accountable for life-threatening complications. An individual's illness perception may affect adherence to treatment which is crucial to prevent complications of HTN. The objective of this study was to identify illness perception and treatment adherence among patients with HTN in a tertiary hospital in Kathmandu, Nepal. Methods: Descriptive correlational study was conducted in the outpatient department of Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu Nepal. Nonprobability purposive sampling was used. A face-to-face interview was conducted from September to December 2018, using a structured questionnaire that included sociodemographic variables, illness perception questionnaire (revised) and Hill bone compliance to high blood pressure therapy scale. Data analysis was done by using descriptive and inferential statistics (chi-square test, Spearman rank correlation). Results: Among 204 participants, 51% were male, 77% were literate, mean ± S.D. age was 60±12. About 72% experienced headache and 88% said that headache is related to HTN. Behavioural factors and psychological factors were regarded as the leading cause of HTN. Almost 63% participants believed HTN as highly threatening illness. Higher scores in timeline (acute/chronic), personal control, and treatment control revealed that patients believed HTN as a chronic disease with a higher rate of personal and treatment control. Regarding treatment adherence, the mean score was 16.58 (SD = 2.08), and only 14.7% had perfect adherence. Participants were more adherent to medication and appointment keeping rather than reduce salt intake. Duration of HTN diagnosis (p=0.027) and duration under HTN medication (p= 0.021) were found to be significantly associated with treatment adherence. There was a significant positive correlation between illness perception and treatment adherence (ρ = 0.282, p<0.01). Conclusion: Illness perception and treatment adherence are correlated. Hence, it is beneficial to improve illness perception to achieve perfect treatment adherence. Reinforcement is essential to maintain adherence to both medications and behaviour therapy.

The role of illness perceptions on medication nonadherence among patients with hypertension: A multicenter study in indonesia

“…We further observed that patient’s comprehension of hypertension was significantly associated with medication nonadherence. This is in accordance with the previous studies conducted in Iran ( Taheri-Kharameh et al, 2016 ) and Nepal ( Shakya et al, 2020 ). The previous studies conducted in Hongkong and India showed that poor understanding of illness is common among patients with hypertension ( Nivedita, 2015 ; Lo et al, 2016 ).…”

“…We observed that the treatment control was significantly associated with medication nonadherence. A previous study conducted in Nepal showed that although patients perceived hypertension as highly threatening, those who have a strong belief that medication will cure their hypertension and prevent complications were reported more adherent to medications ( Shakya et al, 2020 ). Although these patients perceive hypertension as a chronic disease, they believe that it can be controlled with regular medication and behavior modification ( Ross et al, 2004 ; Maharjan et al, 2017 ).…”

Translation, Cultural Adaptation and Validation of the Hill Bone Compliance to High Blood Pressure Therapy Scale to Nepalese Language

“…In Nepal, few studies have been conducted to assess adherence to anti-hypertensive therapy using various tools, however, those tools were not reported to translate into Nepalese language, checked cultural acceptability and carried validity testing. 13 , 18 , 35 Although the general medication adherence measurement scale has been recently validated among Nepalese patients, 36 there is a lack of a specialized valid, reliable, and concise scale to measure medication adherence among Nepalese patients with hypertension. Variation in knowledge level, cultural diversity, lifestyle and socioeconomic statuses among the Nepalese population may affect the adherence level.…”

Perilaku Self Care Management Penderita Hipertensi: Studi Kualitatif

“…Hal ini diperkuat oleh hasil penelitian Shakya, et.al bahwa ada kolerasi antara persepsi dengan kepatuhan penderita dalam melakukan pengobatan Penelitian lainnya melaporkan bahwa persepsi penyakit berhubungan juga dengan kualitas hidup penderita. (Pratiwi, Untari, & Robiyanto, 2020;Shakya et al, 2020). Oleh karena itu meningkatkan persepsi yang positif penderita menjadi penting dilakukan oleh petugas kesehatan.…”