Authors:
- Pédrö Pallangyo
- Makrina Komba
- Zabella Mkojera
- Peter R Kisenge
- Smita Bhalia
- Henry ANSELMO Mayala
- Engerasiya Kifai
- Mwinyipembe K Richard
- Khuzeima Khanbhai
- Salma Wibonela
- Jalack Millinga
- Robert Yeyeye
- Nelson F Njau
- Thadei K Odemary
- Mohamed Janabi
Abstract:
Background: Notwithstanding the availability of effective treatments, asymptomatic nature and the interminable treatment length, adherence to medication remains a substantial challenge among patients with hypertension. Suboptimal adherence to BP-lowering agents is a growing global concern that is associated with the substantial worsening of disease, increased service utilization and health-care cost escalation. This study aimed to explore medication adherence and its associated factors among hypertension outpatients attending a tertiary-level cardiovascular hospital in Tanzania.
Methods: The pill count adherence ratio (PCAR) was used to compute adherence rate. In descriptive analyses, adherence was dichotomized and consumption of less than 80% of the prescribed medications was used to denote poor adherence. Logistic regression analyses were used to determine factors associated with adherence.
Results: A total of 849 outpatients taking antihypertensive drugs for ≥1 month prior to recruitment were randomly enrolled in this study. The mean age was 59.9 years and about two-thirds were females. Overall, a total of 653 (76.9%) participants had good adherence and 367 (43.2%) had their blood pressure controlled. Multivariate logistic regression analysis showed; lack of a health insurance (OR 0.5, 95% CI 0.3-0.7, p<0.01), last BP measurement >1 week (OR 0.6, 95% CI 0.4-0.8, p<0.01), last clinic attendance >1 month (OR 0.4, 95% CI 0.3-0.6, p<0.001), frequent unavailability of drugs (OR 0.6, 95% CI 0.3-0.9, p = 0.03), running out of medication before the next appointment (OR 0.6, 95% CI 0.4-0.9, p = 0.01) and stopping medications when asymptomatic (OR 0.6, 95% CI 0.4-0.8, p<0.001) to be independent associated factors for poor adherence.
Conclusion: A substantial proportion of hypertensive outpatients in this tertiary-level setting had good medication adherence. Nonetheless, observed suboptimal blood pressure control regardless of a fairly satisfactory adherence rate suggests that lifestyle modification plays a central role in hypertension management.
Citations:
Pallangyo, Pédrö & Komba, Makrina & Mkojera, Zabella & Kisenge, Peter & Bhalia, Smita & Mayala, Henry & Kifai, Engerasiya & Richard, Mwinyipembe & Khanbhai, Khuzeima & Wibonela, Salma & Millinga, Jalack & Yeyeye, Robert & Njau, Nelson & Odemary, Thadei & Janabi, Mohamed. (2022). Medication Adherence and Blood Pressure Control Among Hypertensive Outpatients Attending a Tertiary Cardiovascular Hospital in Tanzania: A Cross-Sectional Study. Integrated Blood Pressure Control. Volume 15. 97-112. 10.2147/IBPC.S374674.
https://www.researchgate.net/publication/362585212_Medication_Adherence_and_Blood_Pressure_Control_Among_Hypertensive_Outpatients_Attending_a_Tertiary_Cardiovascular_Hospital_in_Tanzania_A_Cross-Sectional_Study