ACTA FAC MED NAISS 2013;30(4):209-218

Original article

UDC: 616-03:616.12-008.331.1

DOI: 10.2478/afmnai-2013-0013

Medication Adherence in Outpatients with Arterial Hypertension

Jelena Lalić¹, Radmila Veličković Radovanović^1,2,3, Branka Mitić³, Valentina Nikolić⁴, Ana Spasić¹, Goran Koraćević⁵

¹Department of Pharmacy, Faculty of Medicine, University of Niš, Serbia

²Department of Pharmacotherapy, Clinical Centre Niš, Serbia

³Clinic of Nephrology, Clinical Centre Niš, Serbia

⁴Department of Pharmacology, Faculty of Medicine, University of Niš, Serbia

⁵Clinic of Cardiology, Clinical Centre Niš, Serbia


summary

The degree of patient cooperation plays a key role in the success of antihypertensive drug therapy. Non-adherence is the major health and economic problem in the treatment of arterial hypertension (HTA). The aim of the study was to evaluate the degree of adherence in hypertensive patients and to study risk factors affecting adherence and the effects of non-adherence on blood pressure (BP). We performed a cross-sectional study, which involved 170 outpatients with HTA, treated in primary healthcare. Patients were divided into two groups, depending on the degree of adherence, measured using a validated survey form. Statistical analysis was performed using the Pearson's Chi-square and t-test. Good adherence was observed in 126 (74.12%) outpatients. Elderly patients with longer duration of HTA and larger number of drugs in the therapy showed a lower degree of adherence, with more side-effects (p<0.01). Patients younger than 65 years were found to be more likely to adhere to their medication regimen, compared to elderly patients (2=21.3; p<0.01; OR=6.0 95%, CI 2.76-13.04). Uncontrolled BP occurred in the significantly higher percentage in non-adherent patients (59.1%) compared to the adherent group (21.4%) (2=19.84; p<0.01; OR=5.30 95%, CI 2.39-11.85). The most common reason for poor adherence was non-compliance with dosage regimen (27.27%). The medication adherence rate was found to be low among elderly patients. A poor adherence was found to negatively affect BP control. Determining the factors for non-adherence and developing multidisciplinary intervention programs to address the identified factors are necessary to improve adherence to medication and BP control.

Key words: adherence, hypertension, factors of non-adherence