Assessment of Adherence to Treatment among Hypertensive and Diabetic Patients attending Urban Health Centre, Chennai

Abstract

Introduction: Globally, Non communicable diseases (NCD) are the leading cause of death accounting for 63% of annual deaths. More than 40% of NCD deaths are premature deaths which is mainly due to the complication arising as a result of non- adherence to treatment. Moreover, non-adherence to treatment is a growing challenge in India which blocks the clinical outcomes and paves way for complications. Objectives: To Assess the treatment adherence among Diabetic and Hypertensive patients and to determine the factors influencing adherence. Method: Community based, Cross sectional study was conducted among 112 patients of diabetes and hypertension diagnosed for more than 1 year attending NCD clinic of Puliyanthope UHC during Oct-Nov 2020. Data was collected using semi structured questionnaire with socio demographic details, treatment details by interviewer. Adherence was assessed using Morisky Adherence Scale (MAS 4). Results: Among patients, 57% were female and mean age was 54 years with Standard Deviation of 4.5 years. About 39% had diabetes, 27% had hypertension and 34% suffered with both. Total of 34% patients were highly adherent and 66% were non adherent to prescribed drugs. About 64% patients monitored their blood sugar once in three months. Female patients had better adherence (51%) to medications than male (38%) but not statistically significant. About 34% of patients at least once missed their drugs due to high cost. Adherence was high among those who were aware about complications of drug discontinuation. (p = 0.023). Literacy, Socioeconomic status, number of medicines were not significant with treatment adherence (P>0.05). Conclusion: This study indicates high proportion (66%) of non-adherence to treatment among patients with hypertension and/or diabetes. Awareness of impact of discontinuation of drugs had a major impact on adherence to treatment. Common reasons behind low adherence were fear of side effects of drugs, forgetfulness and carelessness.