Medication adherence among hypertensive patients of primary health clinics in Malaysia
PURPOSE
Poor adherence to prescribed medications is a major cause for treatment failure, particularly in chronic diseases such as hypertension. This study was conducted to assess adherence to medications in patients undergoing hypertensive treatment in the Primary Health Clinics of the Ministry of Health in Malaysia. Factors affecting adherence to medications were studied, and the effect of nonadherence to blood pressure control was assessed.


PATIENTS AND METHODS
This was a cross-sectional study to assess adherence to medications by adult patients undergoing hypertensive treatment in primary care. Adherence was measured using a validated survey form for medication adherence consisting of seven questions. A retrospective medication record review was conducted to collect and confirm data on patients' demographics, diagnosis, treatments, and outcomes.


RESULTS
Good adherence was observed in 53.4% of the 653 patients sampled. Female patients were found to be more likely to adhere to their medication regime, compared to their male counterparts (odds ratio 1.46 [95% confidence intervals [CI]: 1.05-2.04; P < 0.05]). Patients in the ethnic Chinese were twice as likely (95% CI: 1.14-3.6; P < 0.05) to adhere, compared to those in the Indian ethnic group. An increase in the score for medicine knowledge was also found to increase the odds of adherence. On the other hand, increasing the number of drugs the patient was taking and the daily dose frequencies of the medications prescribed were found to negatively affect adherence. Blood pressure control was also found to be worse in noncompliers.


CONCLUSION
The medication adherence rate was found to be low among primary care hypertensive patients. A poor adherence rate was found to negatively affect blood pressure control. Developing multidisciplinary intervention programs to address the factors identified is necessary to improve adherence and, in turn, to improve blood pressure control.