Healthy service usage characteristics and treatment symptoms of hypertension hospitals from cardiology policy

Introduction and aim The aim of our study was to determine compliance with drug treatment, adaptation to lifestyle changes, treatment efficacy and health service utilization in patients with hypertension in the tertiary cardiology clinic. Materials and Methods The research is designed as a descriptive study. The sample size was calculated as 384 with 0,05 sample error, 0,05 error margin and with 50% prevalence when the size of the universe is unknown. Between October and October 2016 in ADU Cardiology Clinic, conducted a face-to-face interview and blood pressure was measured using a standardized method. The MMAS scale was used to measure participants's compliance with treatment. Areas with scores of 5 and less point were considered to be in badly compliant, areas with score of 6 and more points were considered to be good compliant with treatment. Statistical analysis of the data was performed using the SPSS 15.0 program. Results The mean age of the participants was 65.1 ± 10.5 (65); 59% (n = 226) were female and 41% (n = 158) were female. 79.2% (n = 304) were married, 44.0% (n = 169) were housewives and 76.8% (n = 295) were less than 9 years old and 55.2% = 212) was between 1380 and 4470 TL. Almost all (96.4%, n = 370) had social security under SGK and 64.3% (n = 247) were living in urban areas. 14.1% (n = 54) of the participants were alcohol and 10.9% (n = 42) were smoking. Those who did not exercise constituted 68.2% (n = 262) of all participants. 84.6% (n = 325) of the participants had at least one additional disease. The most common comorbidities were cardiovascular disease or risk factors (68.5%, s = 263) and DM (40.9%, s = 384). 72.9% (n: 280) 'unda blood pressure control of the participants was provided. The mean systolic blood pressures measured during the study were 127.1 ± 17.50 mmHg and the mean diastolic blood pressure was 79.3 ± 11.4 mmHg. 68.8% (n = 264) of the patients were diagnosed with indefinite HT by second-line healthcare institutions and 58.1% (n = 223) by internal and sub-branch specialists. Almost all of the participants (96.6%; s = 371) who knew the family physician had applied to family physician at least once (93.8%, s = 360); HT was the most frequent reason for application (75.0%; s = 288). Most hypertension patients (95.6%, n = 367) stated that they regularly use hypertension medications. The three most frequent reported cases of irregular use were lack of knowledge (64.7%, n = 11), forgetting to take the medication (58.8%, n = 10) and thought that the medication could harm itself (52.9%, n=9). 39.8% (n = 153) of the participants had not exercised diet and 60.9% (n = 234) since HT was diagnosed; 51.8% (n = 199) of the participants did not fulfill these recommendations when they received advice from their doctor. The mean Morisky score of the participants was 6.1 ± 1.8 (at least 0, at most 8). 67.2% of the participants (n = 258) were in good agreement with the treatment. As age increased (r = 0.253, p = 0.000) and exhaustion compliance (r = 0.101, p = 0.017), compliance with HT treatment increased. In the low and middle income groups (z = 2,507, p = 0,012, and z = 0,012, respectively) in urban areas (z = 2,29; p = 0,02) = 3,146; p = 0,02) treatment compliance was higher. Participants's gender, marital status, level of education, number of daily HT medication doses, number of daily doses of medication, participants' dietary compliance status and presence of someone helping to use medication were not effective on compliance with HT treatment (p> 0.05). Blood pressure control was better in participants who were in urban areas (χ² = 5,627; 0.018), those who had compliance with the recommended exercise regimen (χ2 = 8,821; p = 0,003), and those with higher compliance to drug therapy (χ2 = 5,833; p = 0,016). Age, marital status, level of education, level of income, presence of additional illness, presence or absence of assistant had no effect on blood pressure control. Conclusions Treatment compliance was found to be high in patients with hypertension who applied to our third step. The compliance of the patients with the lifestyle changes and the blood pressure controls were also high. It is thought that in order to get the full result from the treatment, it is necessary to clearly explain the importance of all steps of the patient care. Following the hypertension of the patients, the location of family physicians was found to be limited. Increasing the trust of patients to family physicians can increase the role of family physicians.