NON-ADHERENCE IN HYPPERTENSIVE PATIENTS OF PESHAWAR, PAKISTAN

Introduction: Hypertension is a major risk factor for cardiovascular morbidity and mortality. Adherence to antihypertensive treatment plays an important role in controlling hypertension and reducing mortality and morbidity associated with cardiovascular events. Objectives: The objectives of this study were to determine the frequency of adherent patients among a sample of Peshawar's population, awareness of hypertension in non-adherent patients and to demonstrate the factors responsible for non-adherence in hypertensive patients. Methodology: It was a quantitative, descriptive, cross-sectional questionnaires based study carried out from 05-12- 2013 to 18-03-2014. A convenient sample of 100 hypertensive patients (60 females & 40 males) was gathered from Hayatabad, Phase-4, Peshawar. To assess adherence, 8 item Morisky medication adherence scale was used, whereas, factors were reported via structured questionnaire. Data was analyzed using SPSS v21 and Microsoft Excel 2013 was used for graphs. Results: In our study, 68% of the patients were non-adherent. The mean MMAS score was 5.33 (SD= ± 2.49). Overall awareness of hypertension in non-adherent patients regarding importance of medication use , skipping a dose affect BP, and about cause of hypertension was 95.6%, 60.3% and 91.2% respectively. Among demographic factors, only socioeconomic status was significantly associated with adherence (p=0.02). The top three medication related factors responsible for non-adherence were forgetfulness, (61.76%), symptomless (58.82%) and fear of addiction (51.47%). Conclusion: Different interventions at the level of families of hypertensive patients regarding reducing forgetfulness should be introduced. People should be educated to use the medicine continuously and about the fear of addiction to anti-hypertensive medication via mass media. Keywords: Non-adherence, hypertension, Morisky medication adherence scale, lifestyle modification.