Factors related with non-adherence to pharmacological treatment in hypertensive patients of the “Policlínico XX Aniversario”. An educational program design

Abstract

Introduction: Hypertension is the most common chronic disease in the world, it usually requires pharmacological treatment and the average long-term medication adherence reaches only 50%.

Objective: To evaluate factors related with non-adherence to pharmacological treatment in hypertensive patients at the Policlínico XX Aniversario’s health area in Santa Clara, and to design an educational program on the subject.

Method: A cross-sectional study was carried out in a population of 510 hypertensive patients, from which a random sample of 102 hypertensive patients with pharmacological treatment was selected. An individual interview was conducted to evaluate adherence to treatment (Morisky-Green-Levine test) and other interest data was examined. Ten primary care-related physicians were selected and given a questionnaire to evaluate their knowledge about high blood pressure and its treatment.

Results: The number of hypertensive patients without adherence to pharmacological treatment represented a 58.8%. Incorrect follow-up, inadequate prescribing, and professionals with deficient knowledge about high blood pressure and its treatment contributed to lack of adherence to hypotensive treatment. Finally, a deficiency-based educational program was designed, which consisted of two foldings and educational lectures for patients, and a postgraduate course for physicians.

Conclusions: Non-adherence to pharmacological treatment was associated to poor disease control. Percentage of inadequate prescriptions in the study patients was high and when adequate they were related to better adherence. Primary care physicians’ information needs were: Selection of antihypertensive drugs according to the presence of other diseases and therapeutic guidelines.