Raja Waseem, Ayub Taha, Jeelani Asif, Khan S Muhammad Salim
Department of Community Medicine, Government Medical College, Srinagar, Kashmir, India.
J Family Med Prim Care. 2021 Nov;10(11):4153-4159. doi: 10.4103/jfmpc.jfmpc_668_21. Epub 2021 Nov 29.
Adherence to antihypertensive therapy is an important factor in determining the clinical course of hypertension. This study was planned to estimate adherence to antihypertensive therapy and its determinants among OPD patients attending two primary care hospitals in Kashmir valley.
This study employed a cross-sectional study design. All subjects who reported to OPD between October and December 2020 and had been prescribed antihypertensive medications for at least 1 year were included. Sociodemographic information was collected on a pretested schedule and adherence to medications was assessed by using the-14 item Hill-Bone HBP Compliance to High Blood Pressure Therapy Scale (HB-HBP). Mann-Whitney test and Spearman's rank correlation coefficient were used.
A total of 406 subjects were included in the final analysis with a mean age of 58 years for women and 56 years for men. The sample comprised 54% women. More than 60% of subjects were currently married, urban area residents, and belonged to middle strata of social class. The mean score obtained in the HB-MAS (maximum score 56) was 19.26 (SD ± 4.3). Subjects aged 60 years and above, those belonging to lower socioeconomic class, and subjects prescribed three or more drugs with more than once-daily dosing regimen had higher odds of having poor adherence.
There is suboptimal adherence among OPD patients at primary care level. There is a need for enhanced counselling regarding medication adherence particularly for elderly, poor, illiterate persons and those prescribed multiple medicines with more than once-daily dosing.
坚持抗高血压治疗是决定高血压临床病程的一个重要因素。本研究旨在评估克什米尔山谷两家基层医疗医院门诊患者对抗高血压治疗的依从性及其决定因素。
本研究采用横断面研究设计。纳入所有在2020年10月至12月期间到门诊就诊且已接受抗高血压药物治疗至少1年的受试者。通过预先测试的表格收集社会人口学信息，并使用14项希尔-博恩高血压治疗依从性量表（HB-HBP）评估药物依从性。采用曼-惠特尼检验和斯皮尔曼等级相关系数。
共有406名受试者纳入最终分析，女性平均年龄58岁，男性平均年龄56岁。样本中女性占54%。超过60%的受试者目前已婚，居住在城市地区，属于社会阶层中的中层。HB-MAS（最高分为56分）的平均得分是19.26（标准差±4.3）。60岁及以上的受试者、社会经济地位较低的受试者以及被处方三种或更多药物且每日服药次数不止一次的受试者依从性差的几率更高。
基层医疗水平的门诊患者依从性欠佳。需要加强关于药物依从性的咨询，特别是针对老年人、贫困者、文盲以及被处方多种每日服药次数不止一次药物的患者。
