Baral Phanindra, Poudel Lisasha, Bista Bihunghum, Mali Sushmita, Baral Niraj, Shrestha Archana
National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.
Institute for Implementation Science and Health, Nepal.
J Nepal Health Res Counc. 2025 Jun 29;23(1):158-164. doi: 10.33314/jnhrc.v23i01.5600.
Hypertension is a significant public health concern in Nepal, particularly in rural areas with limited healthcare access. Adherence to antihypertensive medication is critical for adequate blood pressure control and reducing cardiovascular complications. This study aims to assess medication adherence among hypertensive patients and identify associated factors.
A descriptive cross-sectional study was conducted in Namobuddha Municipality, Nepal. A total of 2,024 individuals aged 30 years and older were screened, of which 1,008 were identified as hypertensive. After applying the eligibility criteria, 478 participants were included in the final analysis. Medication adherence was assessed using the Hill-Bone Compliance to High Blood Pressure Therapy (HBCHBPT) Scale. Data were collected through face-to-face interviews using standardized questionnaires and analyzed using STATA version 17. Multivariate linear regression was performed to determine factors influencing adherence.
Among 478 participants, the mean age was 62.12 years, with 55.86% being female. Most participants (91.63%) were on a single antihypertensive medication, and 57.11% had uncontrolled hypertension. The mean medication adherence score was 34.57 ± 1.90. In multivariate analysis, higher hypertension knowledge scores were significantly associated with better medication adherence (? = 0.07, 95% CI: 0.01, 0.13, p = 0.03). Other factors, including age, gender, education, ethnicity, marital status, smoking, alcohol use, physical activity, and social support, were not significantly associated with adherence.
The study found that medication adherence among hypertensive patients was suboptimal, with a significant proportion having uncontrolled blood pressure. Higher hypertension knowledge was associated with better adherence, highlighting the importance of patient education. Strengthening educational interventions and counseling strategies may improve adherence and, consequently, hypertension control.
高血压是尼泊尔一个重大的公共卫生问题,在医疗服务可及性有限的农村地区尤为如此。坚持服用抗高血压药物对于有效控制血压和减少心血管并发症至关重要。本研究旨在评估高血压患者的药物依从性并确定相关因素。
在尼泊尔纳莫布德哈市开展了一项描述性横断面研究。共筛查了2024名30岁及以上的个体,其中1008人被确定为高血压患者。在应用纳入标准后,478名参与者被纳入最终分析。使用希尔-博恩高血压治疗依从性量表(HBCHBPT)评估药物依从性。通过使用标准化问卷进行面对面访谈收集数据,并使用STATA 17版进行分析。进行多变量线性回归以确定影响依从性的因素。
在478名参与者中,平均年龄为62.12岁,女性占55.86%。大多数参与者(91.63%)服用单一抗高血压药物,57.11%的患者血压控制不佳。药物依从性平均得分为34.57±1.90。在多变量分析中,较高的高血压知识得分与较好的药物依从性显著相关(β = 0.07,95%置信区间:0.01,0.13,p = 0.03)。其他因素,包括年龄、性别、教育程度、种族、婚姻状况、吸烟、饮酒、身体活动和社会支持,与依从性无显著关联。
研究发现高血压患者的药物依从性欠佳,很大一部分患者血压控制不佳。较高的高血压知识与较好的依从性相关,突出了患者教育的重要性。加强教育干预和咨询策略可能会提高依从性,从而改善高血压控制情况。