OS 16-05 STUDY OF DETERMINANTS OF NONADHERENCE TO ANTI-HYPERTENSIVE MEDICATIONS IN ESSENTIAL HYPERTENSION AT A TEACHING HOSPITAL IN SOUTHERN INDIA.

OBJECTIVE: Hypertension is a chronic asymptomatic disease, often goes unnoticed for decades before it presents to the medical fraternity with devastating consequences. Low patient adherence is amenable for modification for better control of hypertension, if factors contributing to it are understood. Study was undertaken with the aims of assessing the factors responsible and their relative contributions toward nonadherence among hypertensives.

DESIGN AND METHOD: We conducted a prospective observational study from August 2013 to August 2014. We included those, who attended the medicine outpatient department with a diagnosis of essential hypertension of more than 1 year duration.

RESULTS: A total of 516 patients were enrolled in the study, of which 132 (25.58%) were nonadherent. Marital status (P = 0.017), socioeconomic status (P = 0.000), level of education (P = 0.034), such as, illiteracy was associated with highest level of nonadherence compared with those with pre-matric and undergraduate education, whereas those with post graduate level of education showed absolute adherence to drugs and domiciliary status (P = 0.045) had statistically significant association with nonadherence. Other factors like younger age and male sex were associated with a higher degree of nonadherence; however statistical significance could not be obtained.

CONCLUSIONS: As the reasons for nonadherence are multifactorial, multi-disciplinary approach is needed to tackle this problem. This can be done by better patient health care provider communication, educating the patient regarding the need for drug adherence and probably deleterious consequences of nonadherence and providing the drugs at subsidized rates.