ABSTRACT
To assess patient compliance in systemic hypertension and to identify the causes of non-compliance. A descriptive observational study. The study was conducted in the Department of Medicine Unit I and Unit II at Pakistan Railway Hospital, Rawalpindi, for 1 month from 5th of September, 2012 to 5th of October, 2012. Semi structured interviews of 32 patients with primary hypertension who were admitted in medical ward were done along with their blood pressure readings and their compliance was assessed. Morisky 8-item medication adherence questionnaire1 was used to assess the adherence to anti-hypertensive medication. Scores of less than 3 out of 8 were termed as compliant while scores of 3 or more were termed as non-compliant. Non-compliance was defined as missing at least two days of medications per week. This definition was arrived at from the general understanding that a minimum compliance of 80% is needed to achieve an adequate reduction in blood pressure in the treatment of hypertension.2 Among 32 patients, 18 were male while 14 were female with mean age of 56 years. Twenty six out of thirty two [81.25%] patients did not comply with their antihypertensive medications. In majority of the patients [42.3%], misperception about disease and management due to inadequate education by health care providers was found to be the cause of non-compliance. Other causes were considering medication unnecessary [15.3%] or ineffective [11.5%], forgetting to take them regularly [11.5%], unaffordable drug prices [11.5%] and unpleasant side effects [7.7%]. Patients compliance in hypertension was sub-optimal and misperceptions of the disease and its management seemed to play a major role for non-compliance. Physician-patient relationship, effective communication and better understanding of the disease can result in adequate control of hypertension and its complications