FACTORS ASSOCIATED TO POOR ADHERENCE TO TREATMENT IN THE TUNISIAN ELDERLY

Abstract

Objective: Management of hypertension requires a good adherence to treatment for a successful antihypertensive long-term therapy. Purpose: The aim of our study was to identify the factors associated with poor adherence to treatment in the elderly. Design and method: We conducted a descriptive study including 101 Tunisian hypertensive treated subjects, aged 65 years and over, followed on outpatient basis between November and December 2019. Adherence to treatment was evaluated using EvalOBs, a visual scale of adherence to antihypertensive treatment. Results: Median age was 73 and sex ratio 0.57. Our patients were completely dependent in 4% of cases and among those aged 80 and over, 68.2% were frail. Adherence to treatment was satisfactory in 75.2% of cases. Patients forgot to take their antihypertensive treatment the day of the consultation in 51% of cases and 33% had a medication breakdown since the last consultation. Seventeen per cent of the patients have been away from their treatment because of memory disorder and 7%missed their treatment because some days they feel that the treatment is doing more harm than good. In multivariate analysis, the factors associated with poor adherence to treatment were: male (OR = 11,774; p = 0.013), patient smoker (OR = 0,167; p = 0,02), medication break-down (OR = 0253; p = 0,006) and forgetting the treatment the day of the consultation (OR = 0,159; p = 0,047). Conclusions: Detection of the risk of non-adherence and therapeutic education are necessary to improve the adherence to antihypertensive treatment. The education must be focused on male and smokers and a better medication supply is needed.