Evaluation of medication adherence of patients with hypertension

Though it is not a debate that hypertension is a substantial diseases and even though there are effective medicaments to control the diseases there are difficulties in taking hypertension under control in the world, due to lack of awareness of hypertension patients about the disease, and lack of adherence to the treatment. The objective of our study was to determine medication adherence levels among the patients admitted local outpatient clinics of Ankara Training and Education Hospital Department of Family Medicine, and who have been treated for hypertension longer than six months. Materials and Methods Data Collection, Sample and Design: The study was conducted on 149 volunteer patients admitted to local outpatient clinics of Ankara Training and Education Hospital Department of Family Medicine (Çukurambar, Ministry of Interior, TEDAŞ and State Council district polyclinics) between May, 2016 and June, 2016, and who have been treated for hypertension longer than six months. Inquiry was conducted by the specialist, and face to face with the patients. The questionnaire form consisted of two parts: the first part included 7 questions about sociodemographic characteristics, and lifestyle habits of the patients, and the second part included 8-Item Morisky Medication Adherence Scale. Statistical Analyses: The SPSS 20.0 statistical package was used for analyses. Chisquare test was used to compare qualitative data among the groups, data were presented as numbers and percentages. Relevance of the data for normal distribution was examined using visual (histogram and probability graphs) and analytical (Kolmogorovsmirnov/ shapiro-wilk tests) methods. To compare parametric data student t test was used for two groups' comparison, and One Way Anova test was used for three or more groups' comparisons. The data were presented as the arithmetic mean ± standard deviation, minimum and maximum value. Mann-Whitney and Kruskal-Wallis tests were conducted to evaluate the possible associations between non-parametric terms between two groups, and three or more groups, respectively. Numerical data were presented as median. Pearson correlation analysis was used for correlation analysis in the groups that vii both variables were normal distribution, and Spearman correlation analysis test was used for correlation analysis in the groups without parametric conditions. For statistical significance, type-1 error level was determined as 0.05. Results The mean age of 149 patients participated in the study was 52.9 ± 11.9 years of age (minimum 18 – maximum 79 years). Eighty (54.4%) of the participants were female and 68 (45.6%) were male. The total Morisky score of 149 participants was 6.88 ± 1.1, the lowest score was 3, and the highest score was 8. We found no significant difference of Morisky score in gender (p=0.510), education (p=0,768), profession (p=0.505), treatment methods and doses (p=0.943), and control frequency (p=0.480) groups. We detected that medication adherence decreased as age increased, but not statistically significant. We detected that approximately 80% of the participants represented moderate and high medication adherence. Conclusion We propose that there is a need for further new studies with larger sampling to determine multifactorial factors on medication adherence scale and in order to improve the medication adherence in chronic disease. Primary care physicians are in close contact with patients, as a part of their mission. They should follow-up medication adherence of the patients closely, and in case of suspicion of mis-compliance, physicians are expected to identify and remove the causative factor of mis-adherence and treat the problem with a holistic approach. Key words: Hypertension, family medicine, medication adherence