Improving the drug compliance of hypertensive patients in primary care: Importance of health education and self-management

Abstract

Introduction. Given the prevalence and burden of arterial hypertension, it is necessary to obtain an optimal control of blood pressure in order to improve the prognosis of these patients. Adherence to antihypertensive therapy is poor, leading to non-optimal disease control. The objective of the study was to investigate the adherence to therapy in hypertensive patients and to assess the impact of health education and self-action plan in improving the compliance to the therapy in primary care settings. Material and methods. A prospective study was conducted in 750 patients diagnosed with primary hypertension for 3 years. After inclusion in the study, patients were monitored for 24 weeks to evaluate treatment non-compliance. In patients without adherence to antihypertensive therapy, we used various health education strategies to improve compliance. Results. A total of 750 patients with essential hypertension who started therapy over duration of 3 years were included in the study. At the end of 24 weeks, it was observed that only 324 patients (43.2%) had regular compliance and 426 patients (56.8%) were noncompliant to antihypertensive treatment. The factors that were associated with poor compliance were: a low level of education, burdensome treatment, dislike of drugs, remote pharmacies, concerns about side effects, anger about the condition or its treatment, forgetfulness or complacency, as well as the patients’ poor attitude to health. After employing various strategies for improving the compliance in these patients, the compliance increased in 263 patients (61.7%) among the earlier defaulted patients, while the remaining 163 patients (38.3%) were found to be noncompliant even after various educational techniques. Conclusions. Failure to treat hypertension is a reality, and none of the strategies for improving compliance are likely to be as effective as a good doctor-patient relationship. Optimal self-management, which allows to optimize control of arterial hypertension by adjusting drugs, can be carried out by self-regulation using a written plan of action or by regular medical examination.