Epidemiological correlates of adherence to anti-hypertensive treatment in primary health care setting of Ludhiana, Punjab

Abstract

Background: There is an increasing burden of hypertension in India. The complications arising from hypertension mainly occur due to non-adherence to pharmacological and non-pharmacological interventions. Adherence to pharmacotherapy for hypertension varies from 43-88%. Various socio-demographic factors influence non-adherence. This study determined adherence to treatment among hypertensives and factors associated with non-adherence.Methods: A cross-sectional study was conducted on hypertensive patients visiting OPD of an institutional urban health centre. A predesigned semi-structured questionnaire including socio-demographic profile, treatment-seeking behavior, adherence to medications, and lifestyle risk factors (smoking, intake of alcohol, junk food, and high salt diet) was applied. Reasons for non-adherence were also explored. Data were analyzed using SPSS 26 version.Results: A total of 186 individuals: 113 females (60.8%) and 73 males (39.2%), participated in the study. The mean age of participants was 60.9±10.7 years. Adherence to anti-hypertensive treatment was witnessed in 68.3% of patients. The adherence was noticed significantly (p=0.001) more in literate than illiterate subjects. Further, the adherence was lower among smokers (25%) and alcohol consumers (43.75%) as compared to non-users (70.22% and 73.37%, respectively; p<0.01). Discontinuation of medicine on feeling well, forgetfulness, and unawareness were predominant reasons for skipping medications.Conclusions: Non-adherence to the anti-hypertensives significantly adds to the disease burden. A deeper understanding of factors responsible for the non-adherence plays a pivotal role in addressing this issue and improving quality of life. Intensive health education and counseling of the patients is the need of the hour.