A community-based study to assess the treatment adherence and its determinants among hypertensive patients residing in a rural area of Kancheepuram district, Tamil Nadu

Abstract

Background: Hypertension exerts a massive public health burden on cardiovascular health and health system in India. Objectives: The aim of this study is to assess the level of treatment adherence among the known hypertensive patients in a rural community and identify the determinants for non-adherence to treatment among them. Materials and Methods: A community-based cross-sectional descriptive study was conducted for 2 months in Sembakkam and Kottamedu villages under the rural field practice area of a medical college among known cases of hypertension diagnosed and initiated on antihypertensive therapy at least 3 months back. A total of 170 hypertensive patients were included as study participants using random sampling, and the desired information was obtained using a semi-structured schedule, and details about treatment adherence based on the Morisky Medication Adherence Scale. Ethical clearance was obtained from the Institutional Ethics Committee before the start of the study. Written informed consent was obtained from the study participants before eliciting any information from them. Statistical analysis was done using SPSS version 18. Frequency distributions were calculated for all the variables. Chi-square test was used for testing the significance of association at P = 0.05. Results: Among the study participants, 81 (47.6%) had good medication adherence, whereas 89 (52.4%) had poor adherence. A statistically significant association was observed between indulging in regular physical activity and use of salt-restricted diet and a good level of treatment adherence. Poor adherence to treatment was found more commonly among patients who were prescribed multiple antihypertensive drugs and those with more than once daily dose formulation. Conclusion: The study indicates that prevalence of treatment adherence among hypertensive patients in rural areas of Tamil Nadu was only 47.6% and there is a lot of scope for improvement. The study has also identified the crucial factors responsible for non-compliance to antihypertensive treatment which can assist the health-care policy makers to formulate a comprehensive strategy to achieve adequate compliance.