Balasubramanian Arjun, Nair Sreejith S, Rakesh P S, Leelamoni K
Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ernakulam, Kerala, India.
J Family Med Prim Care. 2018 Jan-Feb;7(1):64-69. doi: 10.4103/jfmpc.jfmpc_423_16.
Poor adherence is an important barrier to adequate blood pressure control among the diagnosed hypertensives. The study aimed at assessing the level of adherence to medication and to identify factors associated with it in people with hypertension in a rural population of Kerala.
A community-based cross-sectional study was conducted in July 2016 among 189 known hypertensives of a rural population in Kerala. Data was collected by interview method using a semistructured questionnaire. Medication adherence was assessed using 4-item Morisky Medication Adherence Scale. Chi-square was used to test the significance of association, and logistic regression was done to identify independent predictors along with odds ratio (OR).
The mean age of study participants was 65.12 ± 11.71 years and the mean duration of disease was 8.69 ± 7.99 years. High adherence was seen in 46% of the patients, while medium and low adherence was seen in 41.3% and 12.7%, respectively. Risk factors of poor adherence identified were poor knowledge of the complications (OR - 2.120; 95% confidence interval [CI] 1.110-4.048), availing government pharmacy (OR - 2.379; 95% CI 1.131-5.004), and being asymptomatic at the time of diagnosis (OR - 2.120; 95% CI 1.110-4.048).
Adherence to medication among people with hypertension in the current study is poor. A comprehensive strategy to improve adherence to antihypertensive medications is the need of the hour.
依从性差是确诊高血压患者血压得到充分控制的一个重要障碍。本研究旨在评估喀拉拉邦农村地区高血压患者的药物治疗依从性水平，并确定与之相关的因素。
2016年7月，对喀拉拉邦农村地区189名已知高血压患者进行了一项基于社区的横断面研究。采用半结构化问卷通过访谈法收集数据。使用4项Morisky药物治疗依从性量表评估药物治疗依从性。采用卡方检验来检验关联的显著性，并进行逻辑回归以确定独立预测因素及比值比（OR）。
研究参与者的平均年龄为65.12±11.71岁，平均病程为8.69±7.99年。46%的患者依从性高，而中等和低依从性分别为41.3%和12.7%。确定的依从性差的危险因素包括对并发症了解不足（OR - 2.120；95%置信区间[CI] 1.110 - 4.048）、使用政府药房（OR - 2.379；95% CI 1.131 - 5.004）以及诊断时无症状（OR - 2.120；95% CI 1.110 - 4.048）。
本研究中高血压患者的药物治疗依从性较差。当前迫切需要一项全面的策略来提高抗高血压药物的依从性。
