Abstract 410: Multimorbidity, Medication Adherence And Blood Pressure Control Among Hypertensive Patients In Primary Care Settings

Abstract

Background: Multimorbidity, defined as having more than one co-existing chronic condition, induces substantial disease burden. This study aimed to evaluate whether multimorbidity is associated with poor medication adherence and poor blood pressure (BP) control. Methods: A multistage, cluster random sampling was adopted to recruit adult hypertensive patients attending general outpatient clinics in Hong Kong in 2012. Data on BP and the number of chronic medical conditions were collected onsite using a standardised protocol. Adherence to medication was assessed by Morisky Medication Adherence Scale (MMAS-8). A binary logistic regression analysis was conducted with multimorbidity as the outcome variable, and poor adherence (MMAS-8 score ≤ 6) and suboptimal BP control (SBP/DBP > 130/80 mmHg for those with diabetes or chronic kidney disease; and > 140/90 mmHg for others) were included as covariates. Results: From a total of 1,445 completed surveys, the proportion of hypertensive patients having 0, 1 and ≥ 2 additional conditions was 53.6% [775/1,445], 37.5% [542/1,445] and 8.9% [128/1,445]. The corresponding rate of poor adherence was 54.3% [379/698], 37.2% [260/698], and 8.5% [59/698], whereas the rate of suboptimal BP control was 48.0% [294/613], 41.3% [253/613], and 10.8% [66/613], respectively. When compared with patients with no additional conditions, multimorbid patients were significantly more likely to have suboptimal BP control (AOR= 1.47, 95% CI 1.18-1.84, p < 0.001). Conclusions: Multimorbidity was common among hypertensive patients, and was associated with poor BP control. They should receive more clinical attention to achieve better clinical outcomes.