Patient compliance in hypertension management and the impact of an intervention for patient' health beliefs on medication compliance

Antroduction and aim Aim of this study; (1) to identify awareness of hypertension and hypertension prevalance and to determine how many patients with hypertansion disease are kept under control and how many of them have been treated; (2) to determine patient compliance to anti-hypertensive treatment and factors which effect to patient compliance: (3) to determine of descriptive data related to compliance: (4) to determine the effect of one attempt to improve compliance. Materials and methods In this sectional study; stratified, systemically and randomized sampling of 18 years and older population in Aydin, was done. Sampling size was determined as 1075. In June- July 2013, survey was performed to participants in their environment with face to face interview method and their blood pressure was measured with standardized method. MMAS scale was used to evaluate patients' compliance to treatment.. Interventional part of the study, small-group discussions were performed with 11 patients who diagnosed HT previously and agreed to participate in the study. Aim of this small group discussions were to influence each other with talking about patient' health beliefs on HT. After 3 and 6 months from small-group discussions, their blood pressure was measured and evaluated patients' compliance to treatment with MMAS again. Results %51,3 of participants were women, %54,6 of them were primary school graduate, %81,1 of them were married, %65,4 of them were living in urban region and their mean age was(±Standard deviation) 45,6±15,5. %38,4 of participants were using no salt before enjoying meal. %5,3 of participants were using alcohol and %30,6 of them were smoking regularly. %64,0 of participants had no exercise. Blood pressure of %24,6 of participants was never eveluated formerly. Hypertension prevalance was determined as %29,4 in our region. %70,1 of all hypertension patients were aware of their illness. %87,3 of patients (%69,9 regularly, %30,1 ırregularly) who were aware of their illness and %61,0 of all hypertension patients were treated. The most commonly used drug group was ARB-diüretic combination. Blood pressure of %54,9 of patients who used medical drugs and %35,4 of all hypertension was under control. %66,5 of patients with MMAS scale mean point 5.82±2.91 were using their medical drugs regularly. Major reasons for non-compliance to treatment were imperceptible symptoms of disease(%24,9) and forgetfulness of patient to take medical drugs(%23,1). Significant relation was not founded between patient compliance to treatment with age, gender, education level, marital status, career, income level, smoking and alcohol using, exercising and having additional disease(p>0,05). Patient compliance to treatment was founded less in patients who live in rural areas, patients who use salt before start eating, patients who measure their BP and go to control regularly than others. .(respectively χ2=13.61 and p<0.001; χ2=13.90 and p=0.003, χ2=13,971 and p=0,007; χ2=33,838 and p<0,001). Patient' medication adherence was founded more after 3 months from small-group discussions than before small-group discussions and after 6 months. The averages of SBP and DBP were less than according to before small-group discussions. Conclusions In our study, prevelance of HT was founded close in average of Turkey and has been no significant change in the last 20 years. An significantly increase were observed on the awareness, treated and control rates. Nevertheless, there are still difficulties in adherence to treatment. Patient' medication adherence was increased with small-group discussions what aimed changing patient' health beliefs, but the effect of this intervention was decreased with time. Therefore, this kind of interference is expected to improve therapy compliance.