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Original Article

J. Islam. Int. Med. Coll.. 2013; 8(1): 48-53

Patient Compliance in Systemic Hypertension and to Identify Causes of Non-Compliance

Muhammad Ali, Jawad Hameed, Muhammad Hamza Zia, Raja Adil Masood, Aamir Shahzad.

Objective: To assess patient compliance in systemic hypertension and to identify the causes of non-compliance.
Study Design: A descriptive observational study.
Place and Duration of Study: The study was conducted in the Department of Medicine Unit I and Unit II at Pakistan Railway Hospital, Rawalpindi, for 1 month from 5th of September, 2012 to 5th of October, 2012.
Materials and Methods: Semi structured interviews of 32 patients with primary hypertension who were admitted in medical ward were done along with their blood pressure readings and their compliance was assessed. Morisky 8-item medication adherence questionnaire1 was used to assess the adherence to anti-hypertensive medication. Scores of less than 3 out of 8 were termed as compliant while scores of 3 or more were termed as non-compliant.
Non-compliance was defined as missing at least two days of medications per week. This definition was arrived at from the general understanding that a minimum compliance of 80% is needed to achieve an adequate reduction in blood pressure in the treatment of hypertension.
Results: Among 32 patients, 18 were male while 14 were female with mean age of 56 years. Twenty six out of thirty two (81.25%) patients did not comply with their antihypertensive medications. In majority of the patients (42.3%), misperception about disease and management due to inadequate education by health care providers was found to be the cause of non-compliance. Other causes were considering medication unnecessary (15.3%) or ineffective (11.5%), forgetting to take them regularly (11.5%), unaffordable drug prices (11.5%) and unpleasant side effects (7.7%).
Conclusion: Patients compliance in hypertension was sub-optimal and misperceptions of the disease and its management seemed to play a major role for non-compliance. Physician-patient relationship, effective communication and better understanding of the disease can result in adequate control of hypertension and its

Key words: Patient compliance, Hypertension, Physician patient relationship

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