Comparison of anti-hypertensive medication compliance between the tea tribe community and the non-tea tribe community seeking treatment from mobile medical units of Assam

Abstract

BackgroundHypertension is the priority non-communicable disease, whose prevalence ranges from 10% to 55% and an estimated pooled prevalence of 16.1% within the tribal communities of India. Poor compliance to medication is a barrier to control hypertension levels and is an emerging public health challenge. Available evidence suggests varying prevalence of medication non-compliance in different parts of the country. To address the access challenge, National Health Mission supported Mobile Medical Units (MMUs) as one of its key strategies to deliver health services to the remote population. But the role of MMUs in medication compliance is underexplored. Paucity of medication compliance evidence is noted from the North-East states of India. ObjectivesTo assess medication compliance to oral medications among hypertensive Tea-tribe (TT) and Non-Tea-tribe (NTT) patients of the MMUs; Understand the ecological factors that may influence medication compliance. MethodsA comparative cross-sectional mixed-method study was conducted among the TT and NTT of Assam. A sample size of 196 was derived for the quantitative data and a random number of 6 per district was selected for qualitative data. Multi-stage Simple Random Sampling and Purposive sampling were used to recruit participants. ResultsAround 2(2%) of TT and 6(6.1%) of NTT reported moderate level of medication compliance. Medication compliance reported unequal distribution in the categories of education with minimum effect size. The qualitative findings reported patient and provider factors influencing medication compliance significantly. ConclusionEnsuring uninterrupted access to medication, patient and provider factors which affect medication compliance should be identified and addressed.