Prevalence of Adherence to Treatment of Hypertension and Its Determinants in Rural Haryana, North India

Sunday, 17 August 2014
Exhibit hall (Dena'ina Center)
Puneet Misra, MD , All India Institute of Medical Sciences, New Delhi, India
Shashi Kant, MD , All India Institute of Medical Sciences, New Delhi, India
Harshal Salve, MD , All India Institute of Medical Sciences, New Delhi, India
K Anand, MD , All India Institute of Medical Sciences, New Delhi, India
Rahul Srivastava, MD , All India Institute of Medical Sciences, New Delhi, India
INTRODUCTION:  Adherence is the single most important modifiable factor that compromises treatment outcome of the hypertension. In India, information about adherence to hypertension treatment and its determinants in rural area is largely unknown and in Idia more then 70% population is rural.

METHODS:  A community based cross-sectional study was carried out in twenty eight villages in Ballabgarh block of Haryana, north India. Sample size of 340 was calculated and adults (≥ 18 years) with self reported hypertension were selected by simple random sampling at community level. Adherence to treatment was studied by both recall and pill count methods. Information about socio-demographic characteristic was also obtained.

RESULTS:  

Out of 350 subjects with self reported hypertension, 190 (54.3%, 95% CI 49 – 59) were not taking any kind of treatment for atleast last one month. Adherence (100%) by recall method was reported among 96 (27.4%, 95% CI 23.0 – 33.3) subjects and by pill count among 66(18.9%, 95% CI: 14.5 – 22.7) subjects. Higher adherence rate was observed among subjects with controlled hypertension.  Symptom free disease period was reported to be most common cause of non-adherence. Factors such as low education status (p = 0.02), younger age (p< 0.001) and tobacco use (p = 0.04) were identified as independent predictors of adherence in multivariate analysis.

CONCLUSIONS:  

Present study reported low adherence for the treatment of hypertension in a rural community of india,  and even the best treatment can be rendered ineffective by poor adherence. Hence, there is urgent need for measures to be taken for adherence and developing adherence monitoring mechanism to address burden to hypertension at community level.

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