RESUMO
INTRODUCTION: Poor adherence is an important barrier to adequate blood pressure control among the diagnosed hypertensives. The study aimed at assessing the level of adherence to medication and to identify factors associated with it in people with hypertension in a rural population of Kerala. SUBJECTS AND METHODS: A community-based cross-sectional study was conducted in July 2016 among 189 known hypertensives of a rural population in Kerala. Data was collected by interview method using a semistructured questionnaire. Medication adherence was assessed using 4-item Morisky Medication Adherence Scale. Chi-square was used to test the significance of association, and logistic regression was done to identify independent predictors along with odds ratio (OR). RESULT: The mean age of study participants was 65.12 ± 11.71 years and the mean duration of disease was 8.69 ± 7.99 years. High adherence was seen in 46% of the patients, while medium and low adherence was seen in 41.3% and 12.7%, respectively. Risk factors of poor adherence identified were poor knowledge of the complications (OR - 2.120; 95% confidence interval [CI] 1.110-4.048), availing government pharmacy (OR - 2.379; 95% CI 1.131-5.004), and being asymptomatic at the time of diagnosis (OR - 2.120; 95% CI 1.110-4.048). CONCLUSION: Adherence to medication among people with hypertension in the current study is poor. A comprehensive strategy to improve adherence to antihypertensive medications is the need of the hour.
RESUMO
BACKGROUND: Increasing life expectancy around the world, an outstanding achievement of our century, has brought with it new public health challenges. India is the second most populous country in the world, with over 72 million inhabitants above 60 years of age as of 2001. The life expectancy in India increased from 32 years in 1947 to over 66 years in 2010, with 8.0% of the population now reaching over 60 years of age. Few studies in India target the health, especially mental health, of this geriatric population. This study aims to estimate the current prevalence of psychiatric disorders in the geriatric population of the rural area of Singanodi,Karnataka, India. METHODS: This cross sectional, epidemiological, community-based study was conducted in a rural health training area of Singanodi, Raichur District, Karnataka, India.The General Health Questionnaire-12, Mini Mental State Examination, and Geriatric Depression Scale were administered to 366 participants. Chi square tests with Yates correction were utilized for statistical analysis using SPSS 19.0 software. RESULTS: We found that 33.9% of the geriatric population in the selected province were above the threshold for mental illness based on the GHQ-12 questionnaire. Females had a higher prevalence of mental disorder at 77.6% (152 out of 196) as compared to males who had a prevalence of 42.4% (72 out of 170). The most common psychiatric disorder was depression (21.9%), and generalized anxiety was present in 10.7% of the study population. Prevalence of cognitive impairment was 16.3%, with a significantly higher percentage of affected individuals in 80+ age group. CONCLUSION: Mental disorders are common among elderly people, but they are not well documented in rural India. The assessment of psychiatric disorder prevalence will help strengthen psycho-geriatric services and thus improve the quality of life of the elderly. A system that ensures comprehensive health care will have to be developed for this purpose as part of our future efforts.
