Publication

Abstract : Prevalence of hypertension is rising in India. Less than one-fifth of the patients in India have their blood pressure under control. Compliance to medications is known to be associated with blood pressure control. In this cross sectional study we measured prevalence of non compliance to anti hypertensive medications and associated factors. We enrolled 166 hypertensive subjects selected by systematic random sampling in community setting of rural Kerala. Voluntary written informed consent was taken from the study participants. They were interviewed with a pilot tested structured questionnaire. Compliance was assessed by brown bag technique. Among the study participants, 61.4% were senior citizen, 58.4% were females, three-fourth were married and 63.2% belonged to middle socio economic class. Majority (87.3%) preferred private facility for treatment. Prevalence of non compliance to anti hypertensive medication was 24.9% (95% CI: 18.2% to 31.6%). Age, gender, socio economic status, awareness of complications and history of adverse reactions attributed to anti hypertensive medication were not associated with non compliance. Opinion that insufficient time was spent for consultation by their doctor turned out to be a significant risk factor for non compliance (adjusted odds ratio: 4.567, 95% CI: 2.079 to 10.031). In conclusion, prevalence of non compliance is considerably lower in rural Kerala compared to other states in South India. We can conclude that offering more explanation, spending more time to clarify patient’s doubts and hence building a good doctor patient relationship would result in better compliance to the medications prescribed.