Socio-Demographic and Lifestyle Factors Influencing Adherence to AntiHypertensive Treatment in a Rural Area of Ludhiana, India

Abstract

Background

Epidemiological transition has caused increase in burden of non-communicable diseases like hypertension

especially in developing countries like India which are further responsible for significant number of deaths among

patients.Untreated hypertension can lead to numerous complications in patients However, there is inadequate

adherence to therapeutical regimen observed among hypertensives with range varying from 19-96% in our country.

Hence, this study was done in a rural area of Ludhiana to determine adherence to anti-hypertensive treatment

among hypertensive patients and explore various socio-demographic and lifestyle factors associated with

adherence

Methodology

A cross-sectional study was conducted among clinically diagnosed cases of hypertension attending OPD at Rural

health Training centre, Pohir over 3-month period, aged above 18 years of age and were on treatment for at least 6

months. A pre-designed semi-structured questionnaire was used to assess the patient’s socio-demographic profile,

treatment seeking behaviour, duration and type of treatment and presence of any complication of hypertension.

Life style related habits like consumption of junk food, extra salt and alcohol, smoking and daily physical exercise

were also assessed. The patients who took medication for less than 80% of week (?5days) were considered as non

adherent. Weight and Height of the patients were measured and Body mass index (BMI) was calculated by using

formula (weight/height2 ). For categorization of BMI, Asia Pacific Classification was used.

Results

Of the 203 total diagnosed cases of hypertension, 184 patients were enrolled in the study, consisting of 104 males

(56.5%) and 80 females (43.5%). The mean age of the subjects was 59.9±11.75 years. Among 184 patients, 128

(69.5%) were adherent to treatment regimen and 56 (30.5%) were non adherent. Medication adherence was

significantly more among literate as compared to illiterate subjects. On assessing lifestyle related habits of the

subjects, it was observed that adherence was significantly higher in patients not consuming alcohol and no extra

salt intake and ones with no junk food preference. Also, complications were significantly higher among non

adherent patients (82.8%) as compared to ones who took their medication regularly (45.2%). Among reasons for

non-adherence to treatment, the most frequent reasons were discontinuation of medication when feeling well

followed by forgetfulness and financial issues amongst others.

Conclusions

Hypertension is becoming a global health issue and is yet a preventable disease if timely and adequately treated.

Non-adherence to drug therapy among anti-hypertensives is a matter worth concern. Improving adherence will not

only reduce complications and mortality among patients but also improve their quality of life and reduce financial

burden. Hence, certain interventions in this regard like health education and behaviour change communication are

utmost essential at community level.