Impact of Socio–Economic, Health and Patient Related Factors on Medication Adherence in Patients with Hypertension and Type II Diabetes

Abstract

Background: Adherence to therapies is a primary determinant for treatment success in chronic diseases. Despite increased awareness, poor adherence to treatments for chronic diseases still remains a global problem. Failure to adherence, seriously affects the patient and the health care system. Aim: The main purpose of this study was to evaluate the level of drug adherence in patients with hypertension and type II diabetes. A prospective cross sectional study was carried out in tertiary care hospitals of Khammam region, Telangana with a size of 2880 patients. A structured questionnaire has been designed using MMAS 8 scale to determine the compliance level and the socioeconomic status of the objects was analyzed by Kuppuswamy scale.  Results: In our study, the following results were reported, age (P <0.001), gender (P <0.001, OR = 1.954), residence (P <0.0001, OR = 3.102), level of education (P <0.0001), profession (p <0.0001), net monthly income (P <0.001), socio economic class (P <0.001), medication Costs (P <0.001 OR = 0.2346), Health Literacy (P <0.001, OR =0.2051), Social support (P <0.001, OR =3.549, 95% CI=2.701 to 4.649). Frequency of Visits (P <0.001, OR =0.09421), No of medications (P <0.001, OR =0.2506), Complexity (P <0.001, OR =0.1862), Self-Monitoring (P <0.001, OR = 0.1011), felt worse (p<0.0001,OR=0.1591). Conclusion: Our results showed that demographic variables, socio economic factors, health care factors had direct influence on medication adherence. Illiterates, lower-economy patients have not followed the recommendations of health care providers who insist on the need to increase drug adherence in primary care. Our findings call for the need to design new interventions on multidimensional factors likely to interfere with this study, such as patient knowledge and information to improve compliance.