Preliminary Report on Non-adherence to Antihypertensive Treatment in Essential Hypertensive Patients: A Community Based Survey

Abstract

A cross-sectional study was conducted on 300 hypertensive patients living in urban and rural community in Rajshahi District of Bangladesh to assess the situation regarding antihypertensive drug non-adherence. Patients aged 35 years or above who are taking antihypertensive drug for at least 6 months were included in the study. About 87% of patients were found non-adherent to treatment. The non-adherent patients had missed taking medication for anywhere from one day to the whole month. The reasons for not taking the medication included forgetfulness (54.1%), busy schedule (13.9.0%), boredom, travel, reluctance to take, and reluctance to buy the medication. Almost 80% of the people know that hypertension is an incurable disease and the disease has no definite sign and symptom. Knowing all these factors why these people are non-adherent to treatment needs further exploration.

Non Compliance Pattern of Anti Hypertensive Treatment

“…That result was approximately similar to Ekram et al study; they reported that 70% were poor and earning < 10,000 taka per month 18 reflecting hypertension is not a disease of rich. Duration of disease has a great negative impact onadherence as it may bore the patient and promote non-adherence.…”

“…Most of the respondents had a poor knowledge of the sideeffects of antihypertensive as reported by Ekramet al 18 .Most of the (87.5%) participant went for follow up when they felt hypertensive, 94%of them missed their follow up in their course of illness, 35% changed medicine for expenses and 27% stop taking drug when BP is under control which indicates poor knowledge on adherence. Regarding perception, about 63% patients felt hypertension is not a curable disease, 77.4% of the respondent said that preservation of previous prescription is important to understand HTN status.…”

“…In this study, the duration of disease ranged from 1 to 15 years, with an average of 3.99(±3.47) years. Ekram et al 18 study found the duration of disease ranged from 1 to 30 years, with an average of 7.2±5.5 years.…”

“…96.7% of the adherent people knew that uncontrolled hypertension can cause brain stroke whereas only 77.1% of the non-adherent people knew that. Ekramet al 18 study reported Three fourth of the patients knew that uncontrolled hypertension can lead to stroke and heart disease. That was similar to our study.…”

<p>Non-Adherence to Prescribed Antihypertensives in Primary, Secondary and Tertiary Healthcare Settings in Islamabad, Pakistan: A Cross-Sectional Study</p>

“…52 In another study conducted in Bangladesh, forgetfulness, busy schedule and boredom were reported as the three main factors for medication non-adherence in hypertensive patients. 53 All of these South Asian studies showed that forgetfulness, feeling well/no need for medicines were the major reasons for medication non-adherence in hypertensive patients.…”