O169 Psychosocial Factors and Drug Therapy Adherence in a Comprehensive Primary Care Hypertension Program Providing Free Access to Care

Abstract

Introduction: Poor adherence to antihypertensive drug therapy (Rx) is a factor in uncontrolled blood pressure (BP) ( 140/90 mm/Hg). Objectives: To assess the relative influence of socio-economic status and psychosocial factors in achieving adherence to Rx in hypertensive patients followed in Chilean primary care centers. Methods: A weighted randomized sample of 513 patients (371 women) from a universe of 1,484 hypertensive patients (average age 55.7 years) was analyzed. Free medical care, Rx and life style modification counseling was provided throughout a government subsidized multidisciplinary program (Cardiovascular Health Program, CHP). Rx adherence was evaluated using a Morisky-Green-Levine test. Previously validated questionnaires for patient-physician relation, family income, education, emotional stress –depression, family cohesion and social network were utilized to assess psychosocial factors. Multiple Rx and years of awareness of hypertension were analyzed. Odds ratio (OR) were obtained after multivariable logistic regression analysis (adjusted for all variables). Results: Adherence was documented in 36.3% of the study group (women 38.4 %, men 28.9%, p<0.001). No adherence was significantly associated to male gender, low family income, low education, inadequate patient-physician relation, and high emotional stressdepression score. Multiple Rx, and years of awareness of hypertension showed no influence on Rx adherence.