Medication Adherence and Blood Pressure Control Among Hypertensive Outpatients Attending a Tertiary Cardiovascular Hospital in Tanzania: A Cross-Sectional Study

Abstract

Background: Notwithstanding the availability of effective treatments, asymptomatic nature and the interminable treatment length, adherence to medication remains a substantial challenge among patients with hypertension. Suboptimal adherence to BP-lowering agents is a growing global concern that is associated with the substantial worsening of disease, increased service utilization and healthcare cost escalation. This study aimed to explore medication adherence and its associated factors among hypertension outpatients attending a tertiary-level cardiovascular hospital in Tanzania. Methods: The pill count adherence ratio (PCAR) was used to compute adherence rate. In descriptive analyses, adherence was dichotomized and consumption of less than 80% of the prescribed medications was used to denote poor adherence. Logistic regression analyses was used to determine factors associated with adherence. Results: A total of 849 outpatients taking antihypertensive drugs for ≥1 month prior to recruitment were randomly enrolled in this study. The mean age was 59.9 years and about two-thirds were females. Overall, a total of 653 (76.9%) participants had good adherence and 367 (43.2%) had their blood pressure controlled. Multivariate logistic regression analysis showed; lack of a health insurance (OR 0.5, 95% CI 0.3-0.7, p<0.01), last BP measurement >1 week (OR 0.6, 95% CI 0.4-0.8, p<0.01), last clinic attendance >1 month (OR 0.4, 95% CI 0.3-0.6, p<0.001), frequent unavailability of drugs (OR 0.6, 95% CI 0.3-0.9, p = 0.03), running out of medication before the next appointment (OR 0.6, 95% CI 0.4-0.9, p = 0.01) and stopping medications when asymptomatic (OR 0.6, 95% CI 0.4-0.8, p<0.001) to be independent associated factors for poor adherence. Conclusion: A substantial proportion of hypertensive outpatients in this tertiary-level setting had good medication adherence. Nonetheless, observed suboptimal blood pressure control regardless of a fairly satisfactory adherence rate suggests that lifestyle modification plays a central role in hypertension management.

Opportunities of Amlodipine as a Potential Candidate in the Evaluation of Drug Compliance during Antihypertensive Therapy

“…The outcome established that 70.6% of patients <65 years attained blood pressure values of <140/90 mm Hg compared to 66.3% among patients ≥65 years [ 15 ]. Similar results were also observed in the study by Pallangyo et al that showed groups of ≤60 vs. >60 years displaying similar adherence of 76.8% vs. 77.1%, respectively [ 16 ]. This is inconsistent with the current research that showed that most of the patients aged 65 years reached their SBP target compared to the subgroup of <65 years.…”

“…In other words, men were more compliant with antihypertensive therapy compared to women [ 22 ]. Conversely, Pallangyo et al documented that males recorded similar adherence to females (75.6 vs. 77.6%) [ 16 ]. Furthermore, patients treated in primary care settings showed a significant reduction in SBP compared to patients treated in secondary and tertiary care settings.…”

“…Differences in group adherence were controlled by factors such as net income, medical co-payment, employment, and the cost of treatment. Forgetfulness was also recorded among 38.3% of the patients and was considered a barrier to adherence [ 16 ]. While the current study established forgetfulness as a barrier to adherence, Gavrilova et al found that some patients did it intentionally.…”

Investigation of Demographic Characteristics of Essential Hypertension Patients Admitted to Cumhuriyet University Health Services Practice and Research Hospital

“…Volume 3 | Issue 3 | 2022 2 http://ijcimr.org/ and high blood pressure (6,7). In addition, it has been determined that weight gain increases the risk of high blood pressure, even if it remains within the normal BMI limits (8).…”

Factores asociados a la adherencia al tratamiento en pacientes hipertensos del Hospital San Juan de Dios de Pisco, 2022

“…A pesar de la disponibilidad de tratamientos efectivos, la naturaleza asintomática de la enfermedad y la interminable duración del tratamiento, la adherencia a la medicación sigue siendo un desafío importante entre los pacientes con hipertensión. Según la OMS, más de la mitad de las personas con hipertensión interrumpen sus antihipertensivos por completo dentro del primer año del diagnóstico y como máximo la mitad de los que continúan con los medicamentos consumen ≥80% de sus regímenes prescritos 2 .…”