Factors Contributing to Lack of Adherence to Antihypertensive Medications Among Patients at Nishtar Hospital in Multan, Pakistan.

Abstract

Hypertension affects 26.7% of Pakistan's population, with only 6% achieving control. This study investigates antihypertensive medication adherence in Multan, focusing on socioeconomic and patient-related factors influencing non-adherence to study the lack of adherence to antihypertensive medications in hypertensive patients and its associated factors at Nishtar Hospital in Multan, Pakistan. This cross-sectional study was conducted among hypertensive patients admitted at Nishtar Hospital Multan, Pakistan. Patients under the age of 20 years were excluded from the study. A self-developed questionnaire was used to gather the demographic details of patients. The Hill-Bone Medication Adherence Scale was used via a non-probability convenience sampling technique to deduce the adherence level in patients. Data analysis was done using SPSS (Statistical Package for the Social Sciences) v23 (IBM Corp., Armonk, NY). p-value < 0.05 was considered significant. Out of 217 respondents, most were female, married, unemployed, and residing in urban areas. Most of them had a higher level of education and a monthly income averaging below 30,000 PKR (Pakistani Rupee). The insight into the hypertensive history showed that most of them had a positive family historyand comorbid conditions, and were hypertensive for more than five years. The majority of the patients had a complex regimen prescribed to them with multiple doses throughout the day. The minority were smokers and had medications provided to them for free, through public or government-funded institutions. More importantly, adherence to the antihypertensive therapy was negatively correlated with the age of the patients (p = 0.004, r = -0.195), complexity of regimen (p = 0.041), multiple dosing (p = 0.039), and cost of medication (p = 0.043). All of these relations were statistically significant. Lack of adherence to antihypertensive medications in hypertensive patients is more common inpopulations belonging to older age groups, complex regimens, multiple doses, and higher medicine fees.