امتثال المرضى المصابين بارتفاع ضغط الدم الذين يحضرون العيادات الاستشارية للطب الباطني بالعلاجات الدوائية في مدينة الامام الحسين(ع) الطبية ─ محافظة كربلاء المقدسة 2018

Compliance of Hypertensive Patients to Medication Attending The Outpatient Clinics Of Internal Medicine in AL-Imam AL-Hussein medical City- Kerbala- 2018

Background

          High blood pressure is a major risk factor for coronary artery diseases and its complications, heart failure, renal insufficiency, stroke and blindness in diabetic patients (1) . It is expected to cause 7.5 million deaths worldwide, around 12.8% of the whole deaths (8) .

          Noncompliance to antihypertensive treatment results in uncontrolled  high blood pressure and poor clinical results. The aims of management hypertensive patients are to prevent complications, improve their quality of life  and reduction of mortality through patient’s  compliance to medication therapy ꓸ

Objectives

          This study is designed to determine the compliance of hypertensive patients attending the consultation clinics of internal medicine in Al-Imam Al-Hussein  medical city with treatment regimen and the causes of noncompliance ꓸ

Patients and methods

         A descriptive cross- sectional study was conducted in the outpatient clinics of Al- Imam Al-Hussein medical city in Kerbala during the period from March through June 2018ꓸ Total study sample was 335 hypertensive patients,  their ages over 25 years who were selected by convenience sampling procedure according to the inclusion criteria . They  were interviewed and assessed using special questionnaire format based on sociodemographic data, Morisky 8- item medication adherence scale (MMAS-8) ,and measuring of blood pressure of each participant was done by the researcher. Data were collected, entered and analyzed using statistical package for social science program (SPSS software version 20).

 Results

           The study revealed that the mean age of the patients was 58.69 ± 11.87 SD years. About 49ꓸ6% of the patients were in the age group of ≥ 60. Males were 43ꓸ3%. Good compliance with treatment was present in only 28.36% of the sample, 25ꓸ67% with partial compliance and 45.97% had poor compliance. Around 70.4%of patients had family history of hypertension.

         About 38ꓸ2 % of the patients were measuring their BP at governmental clinics (primary health care centers or hospitals), while 26ꓸ3%  measure it at private clinics , and 40ꓸ6%  tend to measure their blood pressure monthly .

        Good control of blood pressure was present only in 23.3% of the patients.

       The absence of symptoms was the first isolated cause of non-compliance to medication 21ꓸ9% , followed by forgetfulness 18ꓸ8% , the cost of medication 16ꓸ3% then negligence and carelessness of patients 9.4%,while 23.1% of the patients had more than one specific reason to their poor compliance .

 Conclusions

        The study existing a low rate of medication compliance and low level of blood pressure control with strong association between them. Compliance increased with age, male gender, higher level of education and high income, longer duration of the disease, presence of complications, using healthy diet and having positive believe about hypertension treatment and its consequences. 23.1%  of the patients with poor compliance had more than one specific reason for their low adherence rate, while the main isolated causes were the absence of symptoms followed by forgetfulness ,cost of medication, carelessness and side effects of drug