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Assessment of medication adherence among hypertensive patients: a cross-sectional study

Anup Bhusal, Pradeep R. Jadhav, Yeshwant A. Deshmukh.

Background: Hypertension affects around one billion individuals worldwide and is expected to increase by 29% to reach 1.56 billion by 2025. It is usually asymptomatic, chronic disorder needing lifelong treatment. The objective of this study was to study the medication adherence among hypertensive patients using hill-bone compliance to high blood pressure therapy scale (HILL-BONE CHBPTS) and to compare medication adherence in hypertensive patients with controlled and uncontrolled blood pressure.
Methods: A cross-sectional, observational study was conducted for a period of one year in the Outpatient department of Medicine in a tertiary care hospital, Navi Mumbai. A total of 129 hypertensive patients who were on at least six months on antihypertensive medications were enrolled. Blood pressure was measured and details of drug therapy were noted. Medication adherence was assessed using HILL-BONE CHBPTS and respective scores were calculated.
Results: HILL-BONE CHBPTS scores were on the higher side signifying poor medication adherence among hypertensive patients. HILL-BONE CHBPTS score correlated significantly in a positive direction with diastolic blood pressure, duration of treatment and the number of medications, As per JNC 8 recommendations, 58.9% (76) hypertensive patients were having blood pressure under control, whereas 41.1% (53) were having uncontrolled blood pressure. HILL-BONE CHBPTS scores were significantly higher (reflecting lower adherence) in hypertensive patients with uncontrolled blood pressure than those having optimally controlled blood pressure.
Conclusions: Overall the medication adherence was poor in hypertensive patients. Adherence to therapeutic regimens is an important factor in blood pressure control among hypertensive patients and needs priority. Health education related to medication adherence needs be improved in hypertensive patients.

Key words: Patient compliance, Medication adherence, Hypertension, Hill bone compliance, HILL-BONE CHBPTS

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