Abstract
Background & rationale Poor adherence to medication is a common problem in
handling patients with chronic disease. Induction of patient adherence to a long-term
regimen requires impressive information about the regimen being given and the importance for the patient of following strictly the treatment, together with the full support of
their families.
Objectives To evaluate the adherence to medication and clinical outcomes in hypertensive patients with or without diabetes mellitus.
Methodology A retrospective study of hypertensive patients was conducted by reviewing outpatient medical records from June 2006 to June 2007 at Nangrong Hospital.
Two groups of subjects included men and women aged over 18 years old: the group of
primary hypertensive patients had blood pressure above 140/90mmHg and the group of
hypertensive patients with diabetes mellitus had blood pressure above 130/80 mmHg.
Patients with other causes of hypertension, or blood pressure over 200/120 mmHg, or
who had serious complicating illnesses, such as terminal stage of cancer, chronic renal
failure, chronic liver disease, congestive heart failure, stroke, and uncontrolled angina,
were not included.
Results Among the total of 54 patients, the hypertensive patient group (n=30)
had higher blood pressure than the group with hypertension and diabetes (n=24). The
average ages of patients in the hypertensive group and the group with hypertension and
diabetes group were 60.56±8.97 years and 57.75±7.87 years, respectively. The risk factors,
i.e., cigarette smoking and alcohol consumption, showed no difference in the two groups.
The study disclosed that the major factors for poor adherence were the complexity of
treatment (66.66%, 83.33%) and a poor provider-patient relationship (66.66%, 75%); the
major factors for improving adherence were emphasized value of the regimen (93.33%,
95.83%) and family support (93.33%, 96.66%). Impediments to successful adherence to
medication in individual cases, namely taking drugs at the wrong time (36.66%, 37.50%)
and taking extra doses to make up for missed doses (20.00%, 20.83%), showed no difference in the two groups.
Conclusions Poor adherence to a medication regimen is common, contributing to
substantial worsening of disease, death, and increased health-care costs. Improving adherence requires emphasizing to the patients the value of the regimen, making the regimen simple, medication-taking behavior and family support.
