Abstract
Objective: To determine the adherence levels to antihypertensive medications and its associated factors among primary care attendees in Trinidad. Methods: A cross-sectional study was carried out whereby an interviewer-administered questionnaire was administered to public primary care attendees throughout Trinidad. Non-pregnant hypertensive adults, attending chronic disease clinic on anti-hypertensive medications for at least 1 year were eligible. Results: Of 225 participants (92% response rate), 58% displayed a low level of adherence to anti-hypertensive medications and 73.3% had uncontrolled hypertension, both independent of age, gender, and ethnicity. Experiencing adverse effects to prescribed medications (P=0.003) and self-reported use of herbal/alternative treatment (P=0.024) for hypertension were significantly associated with higher rates of low adherence. Having too many pills to take and fear about the potential effects of these medications on the body were both correlated with low adherence (P< 0.001) Obtaining antihypertensive medications from a national chronic disease assistance program was inversely correlated with low adherence (P= 0.03). There were no statistically significant associations between adherence and average systolic blood pressure (P= 0.20), home self-monitoring (P= 0.75), daily dosing frequency (P= 0.53), or daily number of pills (P= 0.68) Conclusion: Most primary care hypertensive patients who attended chronic disease clinics at primary care health centers around Trinidad were found to have uncontrolled hypertension along with low adherence to antihypertensive medications. Education, screening for herbal use, and improvements to the existing national medication program, are discussed as interventions to improve adherence in this setting. Keywords: Hypertension, Adherence, Antihypertensive medications, Primary Care
Highlights
Hypertension is one of the most common chronic diseases affecting greater than 1 billion people globally according to the WHO.[1]
Poor adherence to antihypertensive medications has been identified as one of the leading causes of failed treatment.[5]. This subsequently leads to worsening uncontrolled hypertension which further predisposes the patient to various hypertension related comorbidities, cardiovascular and cerebrovascular events and frequent changes in medication regimens
From our study it was found that the majority (58%) of the respondents had a low degree of adherence to antihypertensive medications
Summary
Hypertension is one of the most common chronic diseases affecting greater than 1 billion people globally according to the WHO.[1]. This subsequently leads to worsening uncontrolled hypertension which further predisposes the patient to various hypertension related comorbidities, cardiovascular and cerebrovascular events and frequent changes in medication regimens
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