A cross-sectional study was conducted to determine the prevalence and predictors of adherence to modern antihypertensive pharmacotherapy among slum dwellers in Kolkata, India. Prevalence of adherence based on patient self-reports of consuming ≥80% of the prescribed medications over a recall period of 1 week was found to be 73% (95% confidence interval = 68%-78%). Compared with their counterparts, the following patients were more likely to be adherent to treatment: patients hypertensive for ≥5 years (2.98 times), those whose hypertension was detected during checkups for conditions related to hypertension (2.35 times), those living with ≤4 family members (2.01 times), those with family income of ≥3000 rupees (2.56 times), those who were getting free drugs (4.16 times), patients perceiving current blood pressure to be under control (2.23 times), and those satisfied with current treatment (3.77). Those adherent to their prescribed medications were 1.71 times more likely to achieve adequate control of hypertension compared with those who were not adherent.
MagnussonRS. Non-communicable diseases and global health governance: enhancing global processes to improve health development. Global Health. 2007;3:2. http://www.globalizationandhealth.com/content/3/1/2. Accessed February 15, 2009.
EzzatiMHoornSVLawesCMM. Rethinking the “diseases of affluence” paradigm: global patterns of nutritional risks in relation to economic development. PLoS Med. 2005;2:404-412.
4.
ChobanianAVBakrisGLBlackHR; and the National High Blood Pressure Education Program Coordinating Committee. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). JAMA. 2003;42:1206-1252.
World Health Organization. Overview. WHO Global Report: Preventing Chronic Diseases. A Vital Investment. Geneva, Switzerland: WHO; 2005:1-13.
7.
KeameyPMWheltonMReynoldsKMuntnerPWheltonPHeJ. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217-223.
8.
SharmaS. Hypertension and cardiovascular disease in South Asia: no end in sight. J Am Soc Hypertens. 2008;2:125-130.
9.
ReddyKSShahBVargheseCRamadossA. Responding to the threat of chronic diseases in India. Lancet. 2005;366:1746-1751.
10.
GuptaR. Trends in hypertension epidemiology in India. J Hum Hypertens. 2004;18:73-78.
11.
World Health Organization. Chronic Diseases and Poverty. WHO Global Report: Preventing Chronic Diseases: A Vital Investment. Geneva, Switzerland: WHO; 2005:61-73.
12.
DasSKSanyalKBasuA. Study of urban community survey in India: growing trend of high prevalence of hypertension in a developing country. Int J Med Sci. 2005;2:70-78.
13.
KarSSThakurJS. Self-reported prevalence of cardiovascular diseases in an urban area of Chandigarh city. Indian J Commun Med. 2007;32:302-303.
14.
MisraAPandeyRMDeviJRSharmaRVikramNKKhannaN. High prevalence of diabetes, obesity and dyslipidaemia in urban slum population in northern India. Int J Obes. 2001;25:1722-1729.
15.
DebSDasguptaA. A study on risk factors of cardiovascular diseases in an urban health center of Kolkata. Indian J Commun Med. 2008;33:271-275.
16.
KaplanNMOpieLH. Controversies in hypertension. Lancet. 2006;367:168-176.
17.
OsterbergLBlaschkeT. Adherence to medication. N Engl J Med. 2005;353:487-497.
ElliottWJ. What factors contribute to the inadequate control of elevated blood pressure?J Clin Hypertens (Greenwich). 2008;10:20-26.
20.
WhiteHD. Adherence and outcomes: it’s more than taking the pills. Lancet. 2005;366:1989-1991.
21.
ElzubierAGHusainAASuleimanIAHamidZA. Drug compliance among hypertensive patients in Kassala, Eastern Sudan. East Mediterr Health J. 2000;6:100-105.
22.
JoseVMBhallaASharmaNHotaDSivaprasadSPandhiP. Study of association between use of complementary and alternative medicine and non-compliance with modern medicine in patients presenting to the emergency department. J Postgrad Med. 2007;53:96-101.
23.
HeislerMHoganMMHoferTPSchmittdielJAPladevallMKerrEA. When more is not better: treatment intensification among hypertensive patients with poor medication adherence. Circulation. 2008;117:2884-2892.
24.
HashmiSKAfridiMBAbbasK. Factors associated with adherence to anti-hypertensive treatment in Pakistan. PLoS One. 2007;2:1-8.
25.
JinJSklarGEOhVMSLiSC. Factors affecting therapeutic compliance: a review from the patient’s perspective. Ther Clin Risk Manag. 2008;4:269-286.
ChaturvediASinghYKalraJ. Do all non-responders to anti-hypertensive medication need a change in medication regimen?J Indian Acad Clin Med. 2009;10:32-35.
28.
HadiNGooranNG. Determinant factors of medication compliance in hypertensive patients of Shiraz, Iran. Arch Iran Med. 2004;7:292–296.
29.
HyreADKrousel-WoodMAMuntnerPKawasakiLDeSalvoKB. Prevalence and predictors of poor antihypertensive medication adherence in an urban health clinic setting. J Clin Hypertens (Greenwich). 2007;9:179-186.
30.
ShankarPRParthaPShenoyNChandrasekharTSDubeyAK. Knowledge about heart attack and hypertension among individuals attending a cardiac camp in Pokhara city. Kathmandu Univ Med J (KUMJ). 2007;5:273-278.
31.
KaplanRCBhalodkarNCBrownEJJr. Race, ethnicity, and sociocultural characteristics predict noncompliance with lipid-lowering medications. Prev Med. 2004;39:1249-1255.
32.
GazmararianJAKripalaniSMillerMJEchtKVRenJRaskK. Factors associated with medication refill adherence in cardiovascular-related diseases a focus on health literacy. J Gen Intern Med. 2006;21:1215-1221.
33.
VoilsCISteffensDCFlintEP. Social support and locus of control as predictors of adherence to antidepressant medication in an elderly population. Am J Geriatr Psychiatry. 2005;13:157-165.
34.
HowteerakulNSuwannapongNSittilerdRRawdareeP. Health risk behaviours, awareness, treatment and control of hypertension among rural community people in Thailand. Asia Pac J Public Health. 2006;18:3-9.
35.
AekplakornW. Prevalence, treatment, and control of metabolic risk factors by BMI Status in Thai adults: National Health Examination Survey III. Asia Pac J Public Health. 2011;23:298-306.
36.
JoshiPPSalkarRGHellerRF. Determinants of poor blood pressure control in urban hypertensives of central India. J Hum Hypertens. 1996;10:299-303.
