Adherence to antihypertensive medication and its associated factors among patients with hypertension attending a tertiary hospital of Kathmandu, Nepal.

Thesis Report.

SUMMARY:

Hypertension is a major risk factor for cardiovascular disease, which is the leading cause of premature mortality and morbidity globally (1). Patients should adhere to regular medication even if they are asymptomatic. Following the antihypertensive drug regimen can help to regulate blood pressure and reduce the premature mortality (2-4). Since very few hospital based studies on the factors associated with antihypertensive medication adherence has been conducted in Nepal, this study was carried out to assess the level of adherence and factors associated with low level of adherence to antihypertensive medication. This study was conducted using crossectional study design and quantitative research method was used. Study population was diagnosed patients with hypertension visiting cardiology outpatient department of Manmohan Cardiothoracic Vascular and Transplant Center (MCVTC). A total of 308 hypertensive patients diagnosed and prescribed with antihypertensive medication for more than six months and aged 18 years and above were interviewed in Cardiology OPD by Circular systematic random sampling method in December 2022. Data was collected by using 8 items MMAS-8 tool for hypertension to measure the level of adherence. The statistical analysis of collected data was done by using IBM SPSS version 26. Descriptive statistics were used to report the socio-demographic characteristics, medical, clinical, behavioral and awareness and source of information related factors of participants. Bivariate analysis was used to test the association between variables. Multivariate logistic regression model was used to establish the factors associated with low level of adherence to antihypertensive medications. The factors significantly associated with low level of adherence were forgetfulness (AOR 22.5, 95%CI 10.56-47.86), missed medications due to high cost (AOR 3.8, 95%CI 1.249-11.6) and fear to take antihypertensive medications lifelong (AOR 6.043, 95%CI 2.96-12.33).The information received from family member (COR 0.585, 95%CI 0.347-0.989) was also negatively significantly associated with low level of adherence. Strategies to reduce forgetfulness like reminder messaging alarm, efforts to expand scope of national insurance and counseling to reduce misconceptions about medications improving patient education and family support should be carried out to improve adherence to antihypertensive medications.