Medication In Hypertensive Patients Research Articles

Barriers and Facilitators of Medication Adherence in Hypertension Patients: A Meta-Integration of Qualitative Research.

The aim of this qualitative systematic review is to analyze the barriers and facilitators to the uptake of antihypertensive medication in hypertensive patients. The databases of PubMed, Embase, Web of Science, CINAHL, Cochrane Library, MEDLINE, China National Knowledge Infrastructure, Wanfang, VIP, and Chinese Biomedical were searched from inception to June 2023. The studies were screened, extracted, and assessed independently by two researchers. Previously, the researchers used the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research to assess the quality of the included studies. A total of 27 studies were considered, resulting in two combined findings: a good level of knowledge, belief, and behavior and adequate social support were facilitators of medication adherence in hypertensive patients. In contrast, lack of medication literacy, difficulty adapting to roles, reduced sense of benefit from treatment, limited access to healthcare resources, and unintentional nonadherence were barriers. Medication adherence in hypertensive patients remains a challenge to be addressed. Future research should explore how complex interventions using a combination of evidence-based strategies and targeting multiple adherence behaviors (eg, long-term adherence to medication) are effective in improving medication adherence.

Domains of Adherence and Non-Adherence to Anti-Hypertensive Medications in Hypertensive Patients from Kuala Lumpur: A Qualitative Study

Introduction: Previous medication adherence studies primarily focused on the domains of non-adherence in hypertension treatment and less attention has been given on domains that encourage adherence to anti-hypertensive medications. The current study is aimed to identify the domains of adherence and non-adherence to anti-hypertensive medications among hypertensive patients in Kuala Lumpur, Malaysia. Methods: Hypertensive patients from two public health clinics in Kuala Lumpur were invited for in-depth interviews until thematic saturation. Audio recordings from these interviews were transcribed verbatim. Transcripts were then analysed deductively with the guidance of the World Health Organization Medication Adherence Framework to extract the domains of adherence and non-adherence to anti-hypertensive medications. Results: Ten patients who were predominantly Malays and aged 34-73 years old participated the study. Patient-related (encompassing knowledge, attitude, belief and culture, lifestyle, personal barriers, self-efficacy, and cue to action), socioeconomic (encompassing social support), condition-related (encompassing nature of illness and presence of multiple co-morbidities), therapy-related (encompassing experience of receiving treatment, barrier in treatment, and side effects of treatment), and healthcare system (encompassing access to healthcare and healthcare center experience) domains were identified as central to the medication-taking behaviour of hypertensive patients. Conclusion: Sixteen codes of adherence and 22 codes of non-adherence to anti-hypertensive medications were identified, which were distributed across five domains (patient-related, socioeconomic, condition-related, therapy related, and healthcare system domains). These findings can help to inform future development of medication adherence questionnaires, individualised interventions for patients with adherence problems, and targeted health promotion programmes to reduce uncontrolled hypertension.

The Association Between COVID-19 Mortality and ICU Admission Rates and Prior History of Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Use Among Hospitalized COVID-19 Patients With Hypertension in Michigan.

Importance There are conflicting data regarding the safety of the use of angiotensin-converting enzyme inhibitoror angiotensin receptor blocker(ACEI/ARB) medications in hypertensive patients who are susceptible to COVID-19. Objective Our study assesses the association between COVID-19 severity and mortality and the use of ACEIs/ARBs among hospitalized patients with hypertension. Research design, setting, and participants This was a retrospective cohort study. Using the EPIC system of Beaumont Health, Dearborn, Michigan, we identified 5490 patients with COVID-19 who were admitted to the eight Beaumont hospitals. After excluding subjects who have no hypertension and those with missing data, we included 2129 COVID-19 patients who have hypertension. Logistic regression and Cox proportional hazards models were used to analyze the association between history of ACEI/ARB use, intensive care unit (ICU) admission rate, and COVID-19 mortality. Exposure Exposure refers to the use of ACEIs/ARBs as documented in the medical recordsbefore admission to the hospitals. Main outcome The main outcome was 30-dayCOVID-19 mortality and ICU admission rates. Results There were 1281 subjects (60%) with prior ACEI/ARBuse and 848 subjects (40%) with no ACEI/ARBuse. There was no significant association between ICU admission and the use of ACEIs/ARBs (odds ratio {OR} = 0.95, 95% CI = {0.76, 1.19}, p-value = 0.6). Although the unadjusted logistic regression model demonstrated a statistically significant association between history of ACEI/ARB use and COVID-19 mortality (odds ratio = 1.31, 95% CI = {1.05, 1.66},p-value = 0.02), the adjusted logistic regression model failed to show this statistically significant association (odds ratio = 1.20, 95% CI = {0.93, 1.54}, p-value = 0.14). Moreover, we were not able to reveal a statistically significant association between 30-dayCOVID-19 survival and prior use of ACEI/ARBin the adjusted Cox proportional hazards model (hazard ratio {HR} = 1.11, 95% CI = {0.91, 1.40}, p-value = 0.14). Conclusion In this large retrospective study, we conclude that there was no statistically significant association between prior history of ACEI/ARBuse and COVID-19 ICU admission rates or mortality in hypertensive patients hospitalized with COVID-19.

Predictors of Non-Adherence to Medications in Hypertensive Patients.

Elevated blood pressure (BP) is one of the leading causes for developing major cardiovascular events and still represents a major public health challenge worldwide. We aimed to provide data on predictors of poor adherence to medication in hypertensive patients in Serbia. Observational, analytical study was undertaken at a group of 388 patients who refilled their medications in the Pharmacy Institution, "Apoteka Kragujevac", Kragujevac, Serbia between Jan and Mar 2019. Afterward, we conducted a case-control study to evaluate the influence of the variables associated with the adherence. We used a self-developed questionnaire and SF-36 to assess the influence of the quality of life on medication adherence. Results revealed four independent predictors of non-adherence: increased number of medications, living in a city, forgetfulness of the dosing regimen and low energy. The odds of non-adherence were the highest among the participants living in the city and the low energy was the only factor inversely associated with the level of non-adherence. Many factors were associated with the non-adherence to medication. Further studies are needed to find the most appropriate protocol to promote adherence. The four risk factors (increased number of medications, living in a city, forgetfulness of the dosing regimen and low energy) are associated with non-adherence in adult hypertensive patients.

Pengaruh Edukasi Emo-Demo Terhadap Kepatuhan Minum Obat Pasien Hipertensi Pada Peserta Prolanis

The problem of medication adherence in individuals with hypertension remains a challenge, even in developing countries. The purpose of this study was to determine the effect of Emo demo education on adherence to taking medication in hypertensive patients enrolled in the Prolanis program at Puskesmas Sumbersari Lumajang. This study was conducted at Sumbersari Health Center in March 2023. This study used a quasi-experimental research design with a one group pre-post test design. The purposive sampling technique was chosen to select a sample of 50 respondents. This study used the MMAS-8-4 (Morisky Medication Adherence Scale) questionnaire as a measuring tool for medication adherence. Statistical tests using the Wilcoxon Signed Rank test. Before the emo-demo, most of the 22 (44%) respondents were at a low level of compliance. After emo-demo education, most of the respondents were in moderate compliance 33 (66%) and high compliance 14 (28%). The results of bivariate analysis show that Emo demo education has a significant effect on drug compliance in hypertensive patients participating in Prolanis, with a p-value of 0.000 which is smaller than the predetermined level of significance of 0.05. The provision of Emo Demo in health education with a focus on the target group is expected to be facilitated by the puskesmas. Effective medication adherence among hypertensive patients can improve control of blood pressure and prevent complications of the disease.

Analysis of Medication Compliance in Hypertension Patients at the Cempaka Putih District Health Center, Jakarta

Hypertension is characterized by an increase in blood pressure that is systolic (above 140 mmHg) and diastolic (above 90 mmHg), both of which are above the normal range. This can be seen in the medical records of the most hypertension sufferers from March to May as many as 758 respondents. This incident was caused by several things, one of which was non-compliance in taking drugs in Cempaka Putih Health Center patients. This study aims to determine the description of adherence to medication in hypertensive patients. This researcher uses quantitative with descriptive design. The number of samples in this study was 88 which were obtained through convenience sampling and data collection using a questionnaire. The results of this study showed that adherence to medication in hypertensive patients was obedient as many as 67 people (76.1%). Based on gender, namely female. Based on the elderly age above 56 years as many as 38 people (43.2%). Based on the level of education, namely high school graduates as many as 46 people (52.3%). Based on religion, namely Islam as many as 76 people (86.4%). Based on marital status that is married as many as 64 people (72.7%). Based on the work that is not working as many as 49 people (55.7%). Based on the distance of health services that is 1 km as many as 78 people (88.6%). Based on the length of suffering from hypertension that is > 5 years as many as 68 people (77.3%). Based on the number of drugs consumed, namely single as many as 88 people (100%). Based on the type of drug consumed, namely amlodipine as many as 82 people (93.2%).

Factors Associated with Anxiety During COVID-19 Pandemic and Its Association with Hypertension in Saudi Arabia.

Patients with chronic diseases such as hypertension (HTN) are considered a vulnerable group, and they are prone to anxiety and other psychological conditions during pandemics. Very few reports discussed factors related to anxiety and how it is associated with HTN during COVID-19 pandemic. In this project, we aimed to identify the prevalence of anxiety among hypertensive patients in Saudi Arabia during the COVID-19 pandemic. A cross-sectional study was conducted, and data were collected using an electronic self-administered pretested questionnaire distributed via trained data collectors. Data were analyzed using t-test and chi-test. A total of 2135 participants were enrolled in this study. Anxiety was reported in 5% of all participants and 8% of the hypertensive participants. Older age, marital status, higher body mass index (BMI), smoking, and Khat chewing were strongly associated with anxiety among the general population. In addition, less adherence to medication made participants with HTN significantly more anxious. The prevalence of anxiety among hypertensive individuals is higher compared to the general population. Moreover, anxiety is significantly associated with some sociodemographic in the general population, and with less adherence to medications in hypertensive patients. Further studies with data from medical record including more variables are needed to highlight this association.

Assessment of medication adherence among hypertensive patients in a tertiary care teaching hospital in India

Background: Hypertension is a chronic disorder and a prevalent non-communicable disease in India. With the increasing burden of hypertension, adherence to antihypertensive therapy plays a vital role to control blood pressure and preventing its complications. Therefore, this study was done in our tertiary care hospital to understand the medication adherence level in hypertension patients. Aims and Objectives: To assess adherence to antihypertensive medications in hypertensive patients using pre-tested structured questionnaire. Materials and Methods: A prospective observational study was conducted for 3 months in 100 hypertensive patients. The adherence status of patients to antihypertensive medications was assessed using an eight-item Morisky’s Medication Adherence Scale (MMAS-8). Results: Majority of the study participants in our study were >50 years (68%) and females (64%). We observed that patients taking combination therapy better adhered to medication than monotherapy. We assessed in detail the medication adherence level among study participants using MMAS-8 and analyzed the reasons for non-adherence. Conclusion: The medication adherence rate in our study was found to be moderate to high, which needs to be maintained to attain optimal clinical benefit and also to prevent hypertension-related complications.

Comparative study of photoplethysmographic waveforms with application of antihypertensive medication in hypertensive patients.

BackgroundMultiple studies have been published using a pulse oximeter's photoplethysmographic (PPG) capability to detect tissue perfusion. However, the origin of the PPG signal is still debatable.AimA comparative study was performed of PPG waveforms in hypertensive patients before and after treatment with antihypertensive medication. The aim of this study was to observe the changes of PPG waveforms before and after lowering blood pressure in hypertensive patients and then to detect the relationship between blood pressure and PPG waveforms.MethodsThe PPG waveforms of 60 patients with hypertension were collected. After administration of the antihypertensive medication nitroglycerin, PPG waveforms were collected again. The changes of the T3 (time3): This phase occurred between Marker 3 and Marker 4 (this phase occurs mid‐diastolic) angle, before and after the antihypertensive medication treatment, were compared. The statistical analyses of two related groups were performed using the Paired t‐test.ResultsThe blood perfusion waveforms of hypertensive patients before and after antihypertensive medication administration were differently indicated with the tilt angle T3. The slope angle of the T3 phase waveform increased significantly when the blood pressure dropped to normal (−41.9 ± 16.2° vs. −25.6 ± 21.9°, p < .0001), and the tilt angle of some patients was similar to that of adults with normal blood pressure.ConclusionIn patients with hypertension, the tilt angle of the PPG waveform in the T3 phase increased significantly after administration of the antihypertensive medication nitroglycerin. It is worth to conduct deeper research about the relationship between hypertension and the blood perfusion of microcirculation in the diastolic period.

Evaluation of medication adherence and its relevant factors among hypertensive patients: A cross-sectional study in Shahrekord health-care system.

BACKGROUND:Medication adherence means compliance with patient adherence to medication orders, including timely and correct consumption of medication prescribed by a physician. The present study aimed to determine the extent of adherence to hypertension drug medication in patients covered by comprehensive health service centers of Shahrekord, Iran.MATERIALS AND METHODS:A cross-sectional study examined 401 hypertensive patients registered in the Integrated Health Record System (SIB). SIB is a Persian term related to Health Record System. To collect data, Morisky Medication Adherence Scale was used. The questionnaire was completed by the patients and analyzed using SPSS (SPSS Inc., Chicago, Illinois, USA, version 26), Chi-square test, independent t-test, and analysis of variance.RESULTS:The results indicated that adherence to antihypertensive medication was low in 5.7% of patients, while 63.3% of patients had sufficient compliance. Forgetting to take medications (52.9%) was the most common reason for nonadherence to medication in hypertensive patients.CONCLUSION:Given that forgetting to take medications was the main reason for nonadherence to medication in hypertensive patients, designing and implementing necessary trainings by comprehensive health centers to realize the importance of daily use of medication by hypertensive patients and their families are recommended.

DRUG UTILIZATION PATTERN OF ANTIHYPERTENSIVE MEDICATIONS IN A TERTIARY CARE HOSPITAL, SOUTH INDIA

Objective: The objective of the study is to assess drug use pattern of antihypertensive medications in hypertensive patients. Methods: It is a prospective cross-sectional study conducted in the outpatient dispensary, Government Medical College, Thiruvananthapuram for the period of 6 months from January 2019 to June 2019. About 500 prescriptions of patients visiting outpatient dispensary with an antihypertensive prescription were enrolled for the study. Drug use patterns of different classes of antihypertensive medications were analyzed from individual prescriptions. Results: A total of 500 patients were included in this study, among which 281 were male (56.2%) and 219 (43.8%) were female. In 500 patients, 133 patients were treated with monotherapy. In that 42.1% of patients were treated with amlodipine, 28.57% of patients were treated with losartan. In combination therapy most commonly used was double therapy (42.8%) followed by triple therapy (24.2%). Calcium Channel Blockers (56.2%) was most prescribed class of drug followed by Angiotensin Receptor Blockers. Conclusion: This study reveals that calcium channel blockers as most prescribed class of antihypertensive and Amlodipine was the most prescribed antihypertensive. In our study, most of the patients were treated with combination therapy in that double drug therapy was most common. There is a chance of various medication errors, development of adverse drug reaction as majority (290) of patients belong to age above 60 and chances of getting error also increases as combination therapy is most used. Therefore close monitoring is required for such patients.

Effects of medication knowledge on medication adherence among hypertensive patients at Matero level one hospital, Lusaka city, Zambia: a cross sectional study

Background: Medication adherence is the mainstay to good treatment outcomes. Failure to adhere to medication in hypertensive patients may lead to considerable deterioration of the disease resulting in increased costs of healthcare and mortality. Knowledge about the name of the drug, indications and side effects may enhance medication adherence. Therefore, the aim of this study was to assess effects of medication knowledge on medication adherence among hypertensive patients.Methods: This was a cross-sectional study that involved 120 hypertensive patients. A structured questionnaire was used to collect data on demographic characteristics. Adherence was assessed using the 8-item Morisky medication adherence scale while patient’s medication knowledge was assessed using a 7-item scale. Multiple logistic regression was used to assess factors associated with medication adherence.Results: The mean age of participants was 59 years (SD±14.9) and 10 (8.3%), 42 (35%) and 68 (56.7%) had adequate, average and poor medication knowledge respectively. The prevalence of adherence in this study was 37.5%. In multivariable logistic regression analysis, uncontrolled blood pressure (BP) (AOR: 0.38, CI: 0.16-0.90) was associated with lower likelihood of adhering to medication.Conclusions: The adherence level to treatment was low and medication knowledge of hypertensive patients was generally poor. Uncontrolled BP was associated with non-adherence. Patients with uncontrolled hypertension should be given health education and counselling regarding their condition to improve medication adherence.

Factors Associated with Antihypertensive Medication Non-Adherence: A Cross-Sectional Study Among Lebanese Hypertensive Adults.

BackgroundPoor adherence to antihypertensives is associated with negative outcome of the disease as well as loss of health-care resources. Addressing the epidemic of poor adherence requires identifying factors associated with this behaviour. The aim of this study is to describe adherence to antihypertensive medication among Lebanese hypertensive patients and to evaluate the association between socio-economic, patient- and conditions-related factors and non-adherence.MethodsA cross-sectional study was carried out on adherence to antihypertensive medications covering all governorates of Lebanon. This study was conducted between February 2018 and January 2019 on a random sample of 1497 hypertensive patients. A face-to-face questionnaire was used to assess adherence to antihypertensive medication and its determinants according to the five World Health Organization (WHO) main categories. Logistic regression analysis was performed to test the adjusted association between the multiple exposure factors, and drug adherence data were collected by trained interviewers.ResultsAdherence to antihypertensive medications was reported by 1253 (83.7%) of the patients. After multivariate analysis, patients who tried to control their stress level (OR = 0.77, 95% CI [0.38–0.95]), those who had normal BP readings (OR =0.49, 95% CI [0.18–0.97]), and those who believed in the effectiveness of their treatment (OR = 0.31, 95% CI [0.14–0.76]) had a significantly lower chance to exhibit non-adherence to their treatment. However, older patients (OR= 1.87, 95% CI [1.23–2.21]), divorced/separated patients (OR= 2.14, 95% CI [1.31–5.48]), married (OR=1.96, 95% CI [1.27–3.90]), widowed (OR=2.11, 95% CI [1.62–6.50]), obese patients (OR = 1.76, 95% CI [1.21–1.94]), and patients who smoked hookah and cigarettes (OR = 2.62, 95% CI [1.17–6.76]) were more likely to exhibit non-adherence.ConclusionOur study highlights the influence of factors such as old age, marital status, BMI and high level of emotional stress on non-adherence to medication in hypertensive patients. These determinants should be incorporated into adherence improving strategies.

Increasing drug compliance to hypertension patients through android applications in Wonosobo regency province of Central Java Indonesia

Background: Based on data from WHO, it is estimated that 70% of the 57 million deaths that occurred in the world in 2008 were caused by non-communicable diseases. The prevalence of cases of hypertension primary in the District of Wonosobo in the year 2016 as many as 43.30%. Hypertension patients must take medication during their lifetime to prevent rising blood pressure and complications. This research aims to find out the effect of hypertension management through an android application on the practice of adherence to taking medication in hypertensive patients in Wonosobo regency.Methods: This research is a quasi-experimental with a non-randomized pre-post-test control group design. The study is conducted in patients prolanis hypertension as much as 105 respondents were divided into a treatment group 53 respondents and group control of 52 respondents.Results: Results of the study showed the significant influence of the use of android application to practice obedience to drink medicine. Results of Mann Whitney U analysis showed the treatment group experienced a rise in the mean is higher than the group of control. Likewise, the results of the test Wilcoxon which compares the level of compliance before and after treatment obtained value significantly for both groups with a mean group of treatment is higher.Conclusions: The management of hypertension through an android application has proven to be more effective in improving the practice of adherence to taking medication hypertension patients who take part in the prolanis program in Wonosobo regency.

Medication Adherence In Patients With Arterial Hypertension: The Relationship With Healthcare Systems' Organizational Factors.

PurposeArterial hypertension is one of the most common diseases in the world, presenting a great impact on global mortality. Despite having good medication, the best control depends on patient’s adherence. Our aim is to characterize the relationship of adherence to medication in hypertensive patients with consultation length and other organizational factors of healthcare systems.Patients and methodsWe performed a comprehensive review of literature using the MeSH terms “hypertension” and “medication adherence”. 61 articles were selected for inclusion and adherence parameters were extracted, allowing us to estimate the mean adherence for each country. The adherence was then correlated with organizational aspects of healthcare systems: consultation length, number of health providers (doctors, nurses and pharmacists), number of hospital beds, health expenditure and general government expenditure.ResultsAdherence to medication ranged between 11.8% in Indonesia and 85.0% in Australia. There is much heterogeneity in methodology, but the Morisky Medication Adherence Scale was the preferred method, used in 63.6% of the cases. We found no relation with consultation length, but a significant one with the greater number of health professionals available. Some differences were observed when considering European countries or Morisky Medication Adherence Scale alone.ConclusionThe better the drugs, the better the control of blood pressure, if patients take them. Rather than investing in the prescription of more drugs, it is important to address non-adherence and reduce it to promote better blood pressure control. Organizational factors are relevant constraints and depend on administrative and political decisions. Although they are not always considered, they greatly impact the adherence to medication.

Abstract P343: Patients With Cardiovascular Disease Are Not Meeting American Heart Association Secondary Prevention Recommendations

Introduction: In the United States, cardiovascular disease (CVD) is the leading cause of mortality. More than 92 million Americans have one or more types of CVD and 800,000 die from it annually. More than 47% of myocardial infarction survivors and 30% of stroke survivors get recurrent events, and therefore there is need for data on secondary preventive care, if the AHA’s 2020 impact goal is to be achieved. We assessed the hypothesis that patients with CVD were not meeting AHA secondary preventive guidelines, and there was gender and racial disparities in care. Methods: This study is an analysis of the 2017 Behavioral Risk Factor Surveillance System a chronic disease survey conducted by the CDC. The sample included 51,626 subjects with a history of stroke and coronary artery disease. The secondary preventive measures analyzed included: exercise, diet, smoking cessation, alcohol intake, body mass index, use of blood pressure medications in hypertensive patients and the use of aspirin. Gender and racial disparities were analyzed using multiple logistic regression analysis and age, race, education and income were adjusted for in the outcomes. Results: The median age of the study cohort was 69 years (variance=140). White, black and Hispanic patients represented 79.3%, 8.6% and 6.7% respectively. Females comprised 48.5%. Comorbidities included: hypertension (72.8%), dyslipidemia (63.5%), diabetes mellitus (31.5%) and chronic kidney disease (11.5%). Among CVD patients, 57.1% reported ever smoking and 17.4% of them still smoked. Only 39.2% met AHA aerobic exercise guidelines and 12.1% met both the aerobic and muscle strengthening exercise guidelines. Thirty nine percent of CVD patients undertook more than 150 minutes of aerobic exercise and 12% did 1-149 minutes per week. Obesity/overweight was present in 73.8%. Only 67.8% of patients with CVD were using aspirin, 20% were not on any cholesterol medication (not specified whether statin) while among hypertensive patients, 90.1% were on antihypertensive medications. There were major racial and gender disparities in smoking status [women vs men adjusted OR (aOR) 1.23 (1.21 - 1.25), Hispanic vs white aOR 1.71 (1.66 - 1.76)], aspirin [women vs men aOR 0.66 (0.62 - 0.71), Hispanic vs white aOR 0.56(0.47 - 0.58)]. Women were more likely to be on BP medications [women vs men aOR 1.25 (1.22 - 1.29)]. Conclusion: Patients with stroke do not meet AHA lifestyle and aspirin recommendations. There are major gender and racial disparities in the use of CVD secondary preventive measures.

A0856 Compliance to follow up and adherence to medication in hypertensive patients in an urban informal settlement in Kenya

A0856 Compliance to follow up and adherence to medication in hypertensive patients in an urban informal settlement in Kenya

Compliance with follow-up and adherence to medication in hypertensive patients in an urban informal settlement in Kenya: comparison of three models of care.

To determine and compare, among three models of care, compliance with scheduled clinic appointments and adherence to antihypertensive medication of patients in an informal settlement of Kibera, Kenya. Routinely collected patient data were used from three health facilities, six walkway clinics and one weekend/church clinic. Patients were eligible if they had received hypertension care for more than 6 months. Compliance with clinic appointments and self-reported adherence to medication were determined from clinic records and compared using the chi-square test. Univariate and multivariate logistic regression models estimated the odds of overall adherence to medication. A total of 785 patients received hypertension treatment eligible for analysis, of whom two-thirds were women. Between them, there were 5879 clinic visits with an overall compliance with appointments of 63%. Compliance was high in the health facilities and walkway clinics, but men were more likely to attend the weekend/church clinics. Self-reported adherence to medication by those complying with scheduled clinic visits was 94%. Patients in the walkway clinics were two times more likely to adhere to antihypertensive medication than patients at the health facility (OR 1.97, 95% CI 1.25-3.10). Walkway clinics outperformed health facilities and weekend clinics. The use of multiple sites for the management of hypertensive patients led to good compliance with scheduled clinic visits and very good self-reported adherence to medication in a low-resource setting.

The compliance of hypertension patients in taking medication at Sukasada II Primary Health care from January - March 2016

Background: Hypertension is a chronic disease where the adherence to therapy should be given serious attention. Compliance behavior is to obey the doctor's advice or procedure from the doctor about the use of drugs which had been prescribed by a consultation process between the patient and the patient's family physician. The health providers were influenced by two factors: behavioral and non-behavior factors which determined or shaped by three main factors such as predisposing factors, enabling factors, and reinforcing factors. The aim of this study to assess the compliances of taking medication in hypertensive patients at the Sukasada II Buleleng primary health care.Method: It was a quantitative descriptive study. The respondents were all hypertension patients who come to the Sukasada II primary health care from the period of January to March 2016. Data were obtained through interviews and questionnaires distributed to respondents who met the inclusion criteria and exclusion. The univariate and bivariate analysis was conducted in this study.Results: The results of the research show the number of 84 sample contained 1 subjects with good adherence, 14 subjects with moderate adherence, and 69 subjects with less adherence. The cross tabulation showed that poor medication adherence in the elderly (90.9%), followed by male gender (84.1%), low education (82.7%), higher knowledge (85.0%), perception at close distance (85.7%), travel time ≥ 15 minutes (86.0%), route conditions (84.1), do not have access difficulties (83.9), good family support (82.9), the low role of health care (100%), and did not have any comorbidities (83.1%).Conclusion: The trend of hypertensive patients that are not taking medication mostly come from submissive to men, senior citizens, low educational level, and lesser role of healthcare personnel.

‘Integrated Naturopathy and Yoga’ reduces blood pressure and the need for medications among a cohort of hypertensive patients in South India: 3-months follow-up study

Setting and objective‘Manthena Satyanarayana Raju Arogyalayam’ is a 500-bedded hospital in South India that offers ‘Integrated Naturopathy and Yoga’ (INY). Major components of INY package include an unrestricted diet of foods in natural form, daily yogic exercises, meditation for relaxation, patient counselling and health education in a highly structured routine for 15 days. We aimed to determine if INY reduced blood pressure and the need of anti-hypertensive medications in hypertensive patients. DesignObservational cohort study involving pre–post-comparative analysis of patients enrolled between April and July 2015. Blood pressure, anthropometry, blood parameters and compliance to diet and yoga (diet and yoga score on a scale of 0–10) were measured at baseline and 3 months. ResultsOf 104 patients, 80 (77%) had 3-month follow-up. Of them, 79 (99%) achieved target BP control (<140/90mmHg) and 66 (83%) achieved this with >50% reduction in antihypertensive medication dose, and in 8 (10%) patients, all medications were withdrawn. There was a significant increase in diet (2.7–7.4), yoga scores (1.5–5.6) and decrease in body weight, body fat, blood triglycerides and glycosylated haemoglobin levels. ConclusionThese early results are promising and need further study with long-term follow-up.