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Acta Facultatis Medicae Naissensis
2013, vol. 30, iss. 4, pp. 209-218
article language: English
document type: Original Scientific Paper
published on: 25/02/2014
Medication adherence in outpatients with arterial hypertension
aUniveristy of Niš, Faculty of Medicine, Department of Pharmacy
bUniveristy of Niš, Faculty of Medicine, Department of Pharmacy + Clinical Centre Niš
cClinical Centre Niš, Clinic of Nephrology
dClinical Centre Niš, Clinic of Cardiovascular Diseases



The degree of patient cooperation plays a key role in the success of antihypertensive drug therapy. Non-adherence is the major health and economic problem in the treatment of arterial hypertension (HTA). The aim of the study was to evaluate the degree of adherence in hypertensive patients and to study risk factors affecting adherence and the effects of non-adherence on blood pressure (BP). We performed a cross-sectional study, which involved 170 outpatients with HTA, treated in primary healthcare. Patients were divided into two groups, depending on the degree of adherence, measured using a validated survey form. Statistical analysis was performed using the Pearson's Chi-square and t-test. Good adherence was observed in 126 (74.12%) outpatients. Elderly patients with longer duration of HTA and larger number of drugs in the therapy showed a lower degree of adherence, with more side-effects (p<0.01). Patients younger than 65 years were found to be more likely to adhere to their medication regimen, compared to elderly patients (χ2=21.3; p<0.01; OR=6.0 95%, CI 2.76-13.04). Uncontrolled BP occurred in the significantly higher percentage in non-adherent patients (59.1%) compared to the adherent group (21.4%) (χ2=19.84; p<0.01; OR=5.30 95%, CI 2.39-11.85). The most common reason for poor adherence was non-compliance with dosage regimen (27.27%). The medication adherence rate was found to be low among elderly patients. A poor adherence was found to negatively affect BP control. Determining the factors for non-adherence and developing multidisciplinary intervention programs to address the identified factors are necessary to improve adherence to medication and BP control.
For this article there is a related paper (correction, retraction, or comment) which is available here.


adherence; hypertension; factors of non-adherence


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