رسائل ماجيستير
English
2012
Compliance with antihypertensive treatment among the patients who attend the PHC clinics In Hebron
محمد عبد الرحمن مطلق الوريدات, منى حميد
جامعة القدس · فلسطين
The current study is conducted to assess the rate of compliance with treatment regimen or plan of hypertensive patients and the factors that affect their compliance in the primary health care clinics in Hebron district. A cross-sectional design was utilized to achieve this purpose. The data was gathered between 10/07/2010 and 10/08/2010 using a self-reported questionnaire filled by the researcher and another two assistants for 292 patients attending the central primary health care centers in Hebron district (Karanteena: 109, Dora: 83, and Yatta: 100) who met the inclusion and exclusion criteria and agreed to participate in the study. The self-reported questionnaire consisted of ten sections and included 102 items. Statistical analysis was performed using the statistical package for social sciences (SPSS), Version 15. Descriptive statistics, the Chi-squared and Fisher exact tests (p-value ≤0.05) were used to analyze the data. Also binary logistic regression was used to examine the association between the level of blood pressure control and some dependent variables. Analysis of the patients’ characteristics showed that the patients’ age ranged between 37-87 years of which 65.1% were above the age of 55. Regarding their gender, 171(58.6%) were females and 121 (41.4%) were males. Only one fourth (23.6%) of participants were having normal body mass index (18-24.99kg/m2), 53.1% were overweight (25-29.99 kg/m2) and 23.3% were obese (≥30kg/m2). Nearly 61% of them were under the Palestinian poverty line as defined by the Palestinian Central Bureau of Statistics. For the measurement of the participants compliance rate, the researcher adopted different subjective and objective methods. The researcher measured their BP. as indirect indicator for their compliance. He also asked the participants subjective questions about their regularity on the doctor's appointment, their abidance to their doctor's advices regarding the healthy diet and physical activity, and finally their regularity on taking their antihypertensive drugs as they are prescribed to them. The main result of the current study was that, in general, there is a poor compliance rate with the treatment plans among the hypertensive patients. Only 57.9% of the participants in the
Vstudy were compliant with their treatment plans and had their blood pressure controlled below the targeted level of 140/90 mm Hg. And 53.4% were admitted to hospital once or more times due to hypertension. Also, the cross-tabulation between the compliance rate and the independent variables revealed that gender, BMI, and the smoking status have significant effect on BP. 65.75% of the participants suffered from hypertension for less that ten years and 69.5% of them had one or more co-morbidities. 35.29% were on single daily dose of antihypertensive medication, 51.36% were on twice daily dosing and 13.35% were on three doses a day. Also, the findings indicate that, in general, the patients have good family support and encouragement and positive relationship with the treating doctor in the clinic. They also showed variation in their knowledge about hypertension and its treatment and the majority of the participants (72.6%) indicated that the drugs' usage instructions were "always or often" clear and simple. The binary logistic regression analysis revealed a significant relationship between compliance and gender of patients, body mass index, the illness duration in years, the presence of diabetes as co-morbidity, the number of drugs, frequency of doctor visits, the patient's perception of hypertension as a serious disease, the clarity of treatment instructions given to the patient, the family support, the occurrence of drugs side effects and the cost. On the other hand, binary logistic regression showed no statistically significant relationship between compliance and age of the patient, education level, work status, smoking status, marital status, family history of hypertension, daily regimen, and drugs' regimen interruptions. Finally, the participants had low compliance rate (57.9%) with their treatment plans which could have adverse effects on their ability to control their blood pressure level and to minimize or delay the appearance of its complications.
