Junior Resident, Department of Community Medicine, MGM Medical College, Navi Mumbai, Maharashtra, India.
Professor, Department of Community Medicine, MGM Medical College, Navi Mumbai, Maharashtra, India.
Indian J Public Health. 2019 Oct-Dec;63(4):348-352. doi: 10.4103/ijph.IJPH_422_18.
Nonadherence to treatment is a challenge in managing the increasing burden of chronic noncommunicable diseases in India. The issue is not limited only to people having limited access to health-care services, but for a variety of reasons, a typical pattern of nonadherence is being seen.
The objective was to assess the compliance and to find out the reasons of noncompliance to treatment of diabetes/hypertension among previously diagnosed patients from urban slums.
This is a community-based, cross-sectional study conducted during October 2017-February 2018 in urban slums of Belapur, Navi Mumbai, selecting all cases of diabetes and hypertension diagnosed for >1 year by house-to-house survey, covering a population of 4125. A structured and pretested questionnaire including sociodemographic details, treatment details, and compliance pattern was administered.
The study included 208 individuals, of which 164 were under treatment for hypertension and 85 for diabetes. All the patients revealed discontinuation of medication for a significant period at some point since diagnosis. The most common reasons of noncompliance were lack of money (50.58% patients with diabetes, 73.78% patients with hypertension) and difficulty to remember to take daily medication due to work or forgetfulness (49.41% patients with diabetes, 26.21% patients with hypertension). Only 56.5% of patients with diabetes and 64.6% of patients with hypertension were aware that discontinuation of treatment can cause complications, whereas 95.3% of patients with diabetes and 99.4% of patients with hypertension feel that remembering medication at work is difficult.
As the nonadherence is too high, there is an urgent need of attention to this aspect, and remedial measures such as proper counseling to the patient, involvement of family members, and use of low-cost drugs for treatment should be sought.
在印度，慢性病负担不断增加，治疗不依从是一个挑战。这个问题不仅限于那些难以获得医疗服务的人，而且由于各种原因，还出现了一种典型的不依从治疗模式。
评估既往诊断的城市贫民窟患者糖尿病/高血压治疗的依从性，并找出不依从治疗的原因。
这是一项 2017 年 10 月至 2018 年 2 月在孟买纳维克里希纳的城市贫民窟进行的基于社区的横断面研究，通过挨家挨户调查，选择所有诊断出糖尿病和高血压超过 1 年的病例，覆盖人口 4125 人。使用结构化和预测试问卷，包括社会人口统计学细节、治疗细节和依从模式。
该研究纳入了 208 名患者，其中 164 名高血压患者和 85 名糖尿病患者正在接受治疗。所有患者自诊断以来的某个时间段都曾停止服用药物。不依从的最常见原因是缺钱（50.58%的糖尿病患者，73.78%的高血压患者）和因工作或健忘而难以记住每天服药（49.41%的糖尿病患者，26.21%的高血压患者）。只有 56.5%的糖尿病患者和 64.6%的高血压患者知道停止治疗会导致并发症，而 95.3%的糖尿病患者和 99.4%的高血压患者认为在工作时记住药物很困难。
由于不依从率太高，因此迫切需要关注这一方面，并应采取适当的患者咨询、家庭成员参与和使用低成本药物治疗等补救措施。
