Evaluation of Antihypertensive Medication Adherence and Its Association With Blood Pressure Control Among Hypertensive Patients Attending Outpatient Clinics in Khyber Pakhtunkhwa, Pakistan: A Cross-Sectional Study.
Hypertension is a major noncommunicable disease in Pakistan, and suboptimal blood pressure (BP) control remains a significant public health challenge, largely influenced by poor adherence to antihypertensive medications.
This study aimed to assess the prevalence of antihypertensive medication adherence and its association with BP control among hypertensive patients attending outpatient clinics in Khyber Pakhtunkhwa, Pakistan.
This analytical cross-sectional study included 436 hypertensive patients selected through consecutive sampling from tertiary care hospitals. Data were collected using a structured questionnaire and the validated Brief Medication Questionnaire. BP was measured using standardized procedures with a Medico Aneroid Sphygmomanometer AND-85 and the Omron M3 Comfort device (Omron Healthcare, Kyoto, Japan). BP control was defined as <140/90 mmHg. Data were analyzed using Statistical Package for the Social Sciences version 25 (IBM Corp., Armonk, NY). The chi-square test and multivariable binary logistic regression were used to assess associations and adjust for confounders.
Of 436 participants, 196 (44.95%) were adherent and 240 (55.05%) were nonadherent. BP was controlled in 178 (40.83%) patients and uncontrolled in 258 (59.17%). Controlled BP was significantly higher among adherent patients (67.35%) compared with nonadherent patients (19.17%) (P < 0.001). Nonadherence was independently associated with uncontrolled hypertension (adjusted odds ratio = 3.82; 95% confidence interval: 2.45-5.97; P < 0.001). Other significant predictors included age ≥60 years, diabetes mellitus, and longer duration of hypertension.
Medication nonadherence is a major independent and modifiable determinant of poor BP control among hypertensive patients in Khyber Pakhtunkhwa. Targeted adherence-enhancing interventions are urgently needed in outpatient clinical settings.
This study aimed to assess the prevalence of antihypertensive medication adherence and its association with BP control among hypertensive patients attending outpatient clinics in Khyber Pakhtunkhwa, Pakistan.
This analytical cross-sectional study included 436 hypertensive patients selected through consecutive sampling from tertiary care hospitals. Data were collected using a structured questionnaire and the validated Brief Medication Questionnaire. BP was measured using standardized procedures with a Medico Aneroid Sphygmomanometer AND-85 and the Omron M3 Comfort device (Omron Healthcare, Kyoto, Japan). BP control was defined as <140/90 mmHg. Data were analyzed using Statistical Package for the Social Sciences version 25 (IBM Corp., Armonk, NY). The chi-square test and multivariable binary logistic regression were used to assess associations and adjust for confounders.
Of 436 participants, 196 (44.95%) were adherent and 240 (55.05%) were nonadherent. BP was controlled in 178 (40.83%) patients and uncontrolled in 258 (59.17%). Controlled BP was significantly higher among adherent patients (67.35%) compared with nonadherent patients (19.17%) (P < 0.001). Nonadherence was independently associated with uncontrolled hypertension (adjusted odds ratio = 3.82; 95% confidence interval: 2.45-5.97; P < 0.001). Other significant predictors included age ≥60 years, diabetes mellitus, and longer duration of hypertension.
Medication nonadherence is a major independent and modifiable determinant of poor BP control among hypertensive patients in Khyber Pakhtunkhwa. Targeted adherence-enhancing interventions are urgently needed in outpatient clinical settings.
Authors
Adeel Zafar Adeel Zafar, Ahmad Ahmad, Uddin Uddin, Din Din, Ali Ali, Masood Masood, Bonilla Arauz Bonilla Arauz, Noor Noor
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