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

Tytuł:: Non-Adherence to Prescribed Antihypertensives in Primary, Secondary and Tertiary Healthcare Settings in Islamabad, Pakistan: A Cross-Sectional Study.
Autorzy:: Mahmood S; Department of Pharmacy, Quaid-e-Azam University, Islamabad 45320, Pakistan.
Jalal Z; School of Pharmacy, College of Medical and Dental Sciences, Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Hadi MA; School of Pharmacy, College of Medical and Dental Sciences, Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Orooj H; Directorate of Health Services, Metropolitan Corporation Islamabad, Islamabad, Pakistan.
Shah KU; Department of Pharmacy, Quaid-e-Azam University, Islamabad 45320, Pakistan.
Źródło:: Patient preference and adherence [Patient Prefer Adherence] 2020 Jan 14; Vol. 14, pp. 73-85. Date of Electronic Publication: 2020 Jan 14 (Print Publication: 2020).
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: [Auckland, N.Z.] : Dove Press Limited
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Contributed Indexing:: Keywords: Asia; Pakistan; adherence; antihypertensives; blood pressure control; cross-sectional study; hypertension
Entry Date(s):: Date Created: 20200206 Latest Revision: 20220412
Update Code:: 20221213
PubMed Central ID:: PMC6969702
DOI:: 10.2147/PPA.S235517
PMID:: 32021119
: Czasopismo naukowe

Pełny tekst

Objective: This study aimed to assess the prevalence and predictors of non-adherence to antihypertensive medication among patients with hypertension attending various healthcare settings in Islamabad, Pakistan.
Methods: A questionnaire-based cross-sectional study was conducted in selected healthcare facilities between September 2017 and December 2018. The study was conducted in primary, secondary and tertiary healthcare settings in Islamabad, Pakistan. Medication adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8). Sociodemographic and clinical data of recruited patients were collected through a structured questionnaire. Binary logistic regression analysis was performed to determine covariates significantly associated with medication adherence and blood pressure control.
Results: A total of 776 hypertensive patients were invited and 741 (95%) completed the questionnaire. The mean ± SD age of participants was 53.6±12.6 years; 284 patients (38.3%) had high adherence, 178 (24%) had moderate adherence and 279 (37.7%) were non-adherent to the prescribed antihypertensive therapy. Binary regression analysis revealed that old age (OR 1.783 [95% CI: 1.172-2.712]; P =0.013), being educated (OR 2.018 [95% CI: 1.240-3.284]; P =0.036), entitlement to free medical care (OR 1.369 [95% CI: 1.009-1.859]; P =0.044), treatment duration (OR 2.868 [95% CI: 1.913-4.299]; P =0.001), number of medications (OR 1.973 [95% CI: 1.560-2.495]; P =0.001), presence of any comorbidity (OR 2.658 [95% CI: 1.836-3.848]; P =0.001) and blood pressure control (OR 3.103 [95% CI: 2.268-4.247]; P =0.001) were significantly associated with good adherence. Similarly, age (OR 1.998 [95% CI: 1.313-3.040]; P =0.004), entitlement to free medical care (OR 1.498 [95% CI: 1.116-2.010]; P =0.007), treatment duration (OR 1.886 [95% CI: 1.143-3.113]; P =0.013), presence of any comorbidity (OR 1.552 [95% CI: 1.123-2.147]; P =0.008) and adherence level (OR 3.103 [95% CI: 2.268-4.247]; P =0.001) had significant association with controlled blood pressure. The following were the main reasons for non-adherence to prescribed antihypertensive medication: "don't feel need for regular use" (24.7%), "Carelessness" (13.4%) and "adverse effects" (11.2%).
Conclusion: The prevalence of non-adherence to antihypertensive medications was high in the study population and poor medication adherence could potentially explain poor blood pressure control. Evidence-based targeted interventions on both medication adherence and blood pressure control should be introduced and implemented for better treatment outcomes.
Competing Interests: The authors declare that they have no conflicts of interest.
(© 2020 Mahmood et al.)

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