Prevalence of medication adherence and associated factors among hypertensive patients with uncontrolled blood pressure in Sansai Hospital
Keywords:
medical adherence, hypertension, primary care, risk factorAbstract
Introduction In the past 20 years, the prevalence of hypertension among Thai patients has increased from 17% to 24.7%, with only 60% of them having their blood pressure controlled within the standard range. It has been found that one significant factor contributing to this is the lack of cooperation in medication adherence. However, studies in Thailand regarding the factors leading to medication non-adherence in the primary healthcare system are still limited.
Objective: To study the prevalence and factors associated with non-adherence to medication in hypertensive patients with uncontrolled blood pressure at San Sai Hospital, Chiang Mai Province.
Methods: A cross-sectional study was conducted, collecting data from hypertensive patients aged 18 and over who could not control their blood pressure levels (>140/90 mmHg) at San Sai Hospital between October and December 2022. The collected data included age, gender, comorbidities, and presence of a caregiver. Medication adherence was assessed using the Medical Adherence Scale for Thais (MAST). The prevalence and associations of various factors were analyzed using a logistic regression model.
Results: A total of 230 participants were included in the study. The prevalence of medication non-adherence was found to be 35.65% (95% CI: 29.46-42.21). The factors significantly associated with medication non-adherence were having an income of less than 15,000 baht (Adj. Odds ratio 3.21, 95% CI: 1.43-7.18, p-value = 0.005), having chronic kidney disease (Adj. Odds ratio 2.01, 95% CI: 1.00-4.04, p-value = 0.050), and having COPD (Adj. Odds ratio 3.82, 95% CI: 1.32-11.00, p-value = 0.013).
Conclusion: Hypertensive patients with poorly controlled blood pressure in the primary care system are associated with a high rate of medication non-adherence, with up to one-third being non-compliant. Therefore, it is necessary to develop management strategies, including proactive and targeted measures, for the future.
References
Srivanichakorn S. Morbidity and mortality situation of non-communicable diseases (diabetes type 2 and cardiovascular diseases) in Thailand during 2010-2014. Disease Control Journal. 2017;43(4):379-90. [In Thai]
United Nations Thailand, Ministry of Public Health (Thailand), UN Interagency Task Force on NCDs. Prevention and Control of Noncommunicable Diseases in Thailand – The Case for Investment. Bangkok: United Nations Thailand; 2021. Available from: https://www.sdgport-th.org/2021/11/prevention-and-control-of-noncommunicable-diseases-in-thailand-the-case-for-investment/
De Geest S, Ruppar T, Berben L, Schönfeld S, Hill MN. Medication non-adherence as a critical factor in the management of presumed resistant hypertension: a narrative review. EuroIntervention. 2014;9(9):1102-9. doi: 10.4244/EIJV9I9A185.
Aekplakorn W, Abbott-Klafter J, Khonputsa P, Tatsanavivat P, Chongsuvivatwong V, Chariyalertsak S, et al. Prevalence and management of prehypertension and hypertension by geographic regions of Thailand: the Third National Health Examination Survey, 2004. J Hypertens. 2008;26(2):191-8. doi: 10.1097/HJH.0b013e3282f09f57.
Gutierrez MM, Sakulbumrungsil R. Factors associated with medication adherence of hypertensive patients in the Philippines: a systematic review. Clin Hypertens. 2021;27(1):19. doi: 10.1186/s40885-021-00176-0.
Lo SH, Chau JP, Woo J, Thompson DR, Choi KC. Adherence to Antihypertensive Medication in Older Adults With Hypertension. J Cardiovasc Nurs. 2016;31(4):296-303. doi: 10.1097/JCN.0000000000000251.
Rahmawati R, Bajorek B. Factors affecting self-reported medication adherence and hypertension knowledge: A cross-sectional study in rural villages, Yogyakarta Province, Indonesia. Chronic Illn. 2018;14(3):212-27. doi: 10.1177/1742395317739092.
Thirunavukkarasu A, Naser Abdullah Alshahrani A, Mazen Abdel-Salam D, Homoud Al-Hazmi A, Farhan AB, Awad Alsaidan A, et al. Medication Adherence Among Hypertensive Patients Attending Different Primary Health Centers in Abha, Saudi Arabia: A Cross-Sectional Study. Patient Prefer Adherence. 2022;16:2835-44. doi: 10.2147/PPA.S388365
Woodham N, Taneepanichskul S, Somrongthong R, Auamkul N. Medication adherence and associated factors among elderly hypertension patients with uncontrolled blood pressure in rural area, Northeast Thailand. Journal of Health Research. 2018;32(6):449-58. doi: 10.1108/JHR-11-2018-085
Ezeala-Adikaibe BA, Mbadiwe N, Okudo G, Nwosu N, Nwobodo N, Onyebueke G, et al. Factors Associated with Medication Adherence among hypertensive Patients in a Tertiary Health Center: A Cross-Sectional Study. Arch Community Med Public Health. 2017;3(1):024-31. doi: http://dx.doi.org/10.17352/2455-5479.000021
Sathapornnanon N. Medication non adherence. Thai Journal of Pharmacy. 2012;7(1):23-39. doi: https://doi.org/10.14456/tbps.2012.2 [In Thai]
National High Blood Pressure Education Program. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Bethesda (MD): National Heart, Lung, and Blood Institute (US); 2004. Available from: https://www.ncbi.nlm.nih.gov/books/NBK9630/
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021-3104. doi:10.1093/eurheartj/ehy339.
Jongwilaikasem K, Lerkiatbundit S. Development of the Medication Adherence Scale for Thais (MAST). Thai Journal of Pharmacy Practice. 2021;13(1):17-30. [In Thai]
Schneider J, Kaplan SH, Greenfield S, Li W, Wilson IB. Better physician-patient relationships are associated with higher reported adherence to antiretroviral therapy in patients with HIV infection. J Gen Intern Med. 2004;19(11):1096-103. doi: 10.1111/j.1525-1497.2004.30418.x.
Ramli A, Ahmad NS, Paraidathathu T. Medication adherence among hypertensive patients of primary health clinics in Malaysia. Patient Prefer Adherence. 2012;6:613-22. doi: 10.2147/PPA.S34704.
Burnier M. Drug adherence in hypertension. Pharmacol Res. 2017;125(Pt B):142-49. doi: 10.1016/j.phrs.2017.08.015.
Hometowska H, Swiatoniowska-Lonc N, Klekowski J, Chabowski M, Jankowska-Polanska B. Treatment Adherence in Patients with Obstructive Pulmonary Diseases. Int J Environ Res Public Health. 2022;19(18):11573. doi: 10.3390/ijerph191811573.
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