Abstract

ASSESSMENT OF ADHERENCE TO CARDIOVASCULAR MEDICINES IN RURAL POPULATION ATTENDING A TERTIARY CARE TEACHING HOSPITAL

N. Nabi, R. Agarwal, N. Nigam* and P. Pranjal

Abstract

Introduction: Nonadherence to cardiovascular medication is a great public health concern, increasing the morbidity and mortality of patients. This study was conducted to evaluate the adherence to cardiovascular medications in rural Indian setting. Methods: This study was conducted over a period of 12 months, jointly by the department of medicine and pharmacology. The patients diagnosed with essential hypertension (HTN), congestive cardiac failure (CCF), and ischemic heart disease (IHD) attending the out-patient clinics of medicine as well as the inpatients from medicine ward were included in the study. In the first visit, the patients were prescribed cardiovascular medicines by the concerned physician and adherence to these medicines was assessed in the subsequent visits. The Four Items Morisky’s Medication Adherence Scale (MMAS-4) was used for assessing adherence to medication. Results: The results of our study reflect that the adherence to cardiovascular medication was 20.83%, 28.37% and 32% in HTN, CCF and IHD patients, respectively. Nonadherence was found highest among the patients of HTN. Forgetfulness at 45.66% was the most common and carelessness at 7.16% was the least common cause of nonadherence in all the three categories of patients. 68% of HTN patients were on single antihypertensive drugs whereas, 32% of HTN patients were on combination antihypertensive drugs. Conclusion: Nonadherence to cardiovascular medications is a major public health concern amongst the patients of rural India. Policy makers should develop strategies for detecting the level of adherence to cardiovascular medicines, evaluating the barriers of adherence and designing subsequent interventions to overcome it.

Keywords: Adherence, cardiovascular medicines, congestive cardiac failure, essential hypertension, ischemic heart disease, rural population.