Original Article Barriers to and determinants of medication adherence among hypertensive patients attended National Health Service Hospital, Sunderland Muhammad Umair Khan, Shahjahan Shah1, Tahir Hameed2

College of Pharmacy, Ziauddin University, 4‑B Shahra e Ghalib, Clifton, Karachi, Pakistan, 1 Department of Pharmacy Services, Dr. Sulaiman Al Habib Hospital, Buraidah, Qassim, Saudi Arabia, 2Department of Pharmacy, Health and Well‑being, University of Sunderland, Sunderland, Tyne and Wear, UK

ABSTRACT

Address for correspondence: Mr. Muhammad Umair Khan, E-mail: umair104@yahoo. com

Background: Hypertension is a silent killer, a time bomb in both the developed and developing nations of the world. It is one of the most significant risk factors for cardiovascular morbidity and mortality resulting from target‑organ damage to blood vessels in the heart, brain, kidney and eyes. Adherence to long‑term therapy for chronic illnesses like hypertension is an important tool to enhance the effectiveness of pharmacotherapy. Objective: The two objectives of this study were to evaluate the extent and reasons of non‑adherence in patients attended National Health Service (NHS) Hospital, Sunderland. Materials and Methods: The study was conducted for 4 months in the out‑patient department of NHS Hospital. A total of 200 patients were selected randomly for this study. Morisky’s Medication Adherence Scale was used to assess the adherence rate and the reason of non‑adherence. Data were entered and analyzed using Microsoft Excel 2010. Results: The overall adherence rate was found to be 79% (n = 158). Adherence rate in females were low was compared with their male counterparts (74.7% vs. 85.7%). The higher rate of adherence was found in age group of 30‑40 years (82%, n = 64). The major intentional and non‑intentional reason of non‑adherence was side‑effects and forgetfulness respectively. Conclusion: Overall, more than three‑fourth of the hypertensive participants were found to be adherent to their treatment. On the basis of factors associated with non‑adherence, it is analyzed that suitable therapy must be designed for patients individually to increase medication adherence and its effectiveness.

Received : 30‑08‑13 Review completed : 11‑12‑13 Accepted : 17‑12‑13

KEY WORDS: Adherence, barriers, hypertension

M

edication adherence is generally defined as the extent to which patient takes medication as prescribed by the medical practitioner.[1] Adherence depends on many factors as its prevalence has been shown by many studies in range from 0% to 100% respectively.[2,3] Non‑adherence to prescribed medications has been a global problem as studies have shown that it has affected the most in patients with chronic illness such as diabetes and hypertension.[4,5] It is therefore an important issue which is directly linked with the management of chronic diseases Access this article online Quick Response Code:

Website: www.jpbsonline.org DOI: 10.4103/0975-7406.129175

as it has been established that the medication non‑adherence lowers the treatment effectiveness and raises medication cost.[6] All stakeholders in healthcare system concerns the problem of non‑adherence the most due to the scarcity of healthcare resource. The prevalence of non‑adherence is affected by the choice of drug, use of concomitant medications, tolerability of drug and duration of drug treatment, which concludes from the analysis of multiple patient population.[7] Hypertension is a devastating chronic disease which has affected patients from every part of the world and is rank third as a cause of disability adjusted life years.[8] Joint National Committee VII states that there are more than 1 billion hypertensive patients world‑wide.[9] In Britain, however, prevalence of hypertension is 11.7% for ages; 14.4% for those aged more than 16 years; and 46% in those over 65 years of age.[10] Another study showed that age and sex‑adjusted prevalence of hypertension was 28% in the North American countries and 44% in the European countries at

How to cite this article: Khan MU, Shah S, Hameed T. Barriers to and determinants of medication adherence among hypertensive patients attended National Health Service Hospital, Sunderland. J Pharm Bioall Sci 2014;6:104-8. 

104

Journal of Pharmacy and Bioallied Sciences April-June 2014 Vol 6 Issue 2

Khan, et al.: Medication adherence in hypertensive patients

the 140/90 mm Hg threshold.[11] In Asian country like Pakistan it was estimated that hypertension affects 18% of adults and 33% of adults above 45‑year‑old. In another report, it was shown that 18% of people in Pakistan suffer from hypertension with every third person over the age of 40 becoming increasingly vulnerable to a wide range of diseases.[12] With respect to gender, from 1999 to 2004, blood pressure control increased in men from 39% to 51% (P 

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

Hypertension is a silent killer, a time bomb in both the developed and developing nations of the world. It is one of the most significant risk factors...
349KB Sizes 2 Downloads 3 Views