Medication Adherence Among Patients with Arterial Hypertension

Abstract

Background: According to the World Health Organization (WHO), arterial hypertension accounts for approximately 58% of the causes of cardiovascular disease (CVD) incidence and mortality. Consistent adherence to antihypertensive medication significantly reduces morbidity and mortality associated with cardiovascular diseases. Evidence from pharmacological treatment outcomes indicates that approximately half of individuals with hypertension do not receive antihypertensive drug therapy. Moreover, the proportion of untreated hypertension is higher among men (55.2%) compared with women (45.6%). However, studies assessing medication adherence among patients with arterial hypertension remain limited, which provided the rationale for conducting this study. Aim: To determine the level of medication adherence among patients with arterial hypertension. Materials and Methods: A cross-sectional study design was employed. General study information was collected using a structured questionnaire, and medication adherence was assessed using the Morisky Medication Adherence Scale-8 (MMAS-8) developed by Dr. Donald Morisky. The scale consists of eight questions. The total adherence score was categorized as follows: 8 points – high adherence; 6–7 points – moderate adherence; and <6 points – low adherence. Ethical approval for the study was obtained from the Research Ethics Committee of the Mongolian National University of Medical Sciences (MNUMS) according to Resolution No. 2023/3-07 of the meeting held on June 16, 2023. Statistical analysis: Statistical analysis of medication adherence was performed using SPSS version 29. A p-value <0.05 was considered statistically significant. Results: A total of 600 patients aged 25–85 years participated in the study. Among them, 14.8% (n=89) were aged 25–45 years, 29.3% (n=176) were aged 46–55 years, 38.7% (n=232) were aged 56–65 years, 15.5% (n=93) were aged 66–75 years, and 1.7% (n=10) were aged 76–85 years. The mean age was 56.35±9.9 years. The mean body weight was 73.95±13.69 kg, mean height 161.21±9.92 cm, and mean body mass index (BMI) 28.37±5.03 kg/m² (28.08 kg/m² in men and 28.53 kg/m² in women). The mean systolic blood pressure was 131.93±17.42 mmHg (135.0 mmHg in men and 130.0 mmHg in women), and the mean diastolic blood pressure was 83.58±13.3 mmHg. Regarding lifestyle factors, 27.3% (n=164) of the participants were smokers and 72.7% (n=436) were non-smokers, while 21.5% (n=129) reported alcohol consumption and 78.5% (n=471) did not consume alcohol. Based on the Morisky Medication Adherence Scale, medication adherence among patients with arterial hypertension was classified as high in 14.8% (n=89), moderate in 7.2% (n=43), and low in 78.0% (n=468). Conclusion: Evaluation of medication adherence among patients with arterial hypertension revealed that approximately one in five patients demonstrated inadequate adherence to antihypertensive medication.