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Medication Adherence and Health-Related Quality of Life Among Hypertensive Patients in Nepal: A Cross-Sectional Study
Supuspa Lama1, Prasanna Dahal1,2, Sunil Neupane3
1Department of Pharmacy Purbanchal University School of Health Sciences, Gothgaun Sundarharaicha Nepal.
Background:
Good adherence to antihypertensive medication is critical for optimal blood pressure control and reducing disease-related complications. This study aimed to assess patients' medication adherence and health-related quality of life (HRQoL) and explore the relationship between medication adherence and HRQoL among hypertensive patients.
Methods:
A cross-sectional study was carried out at the Scheer Memorial Adventist Hospital (SMAH) in Bagmati Province, Nepal, from March 2023 to June 2023. The General Medication Adherence Scale (GMAS) and the European Quality of Life-5 Dimensions-5 Levels (EQ-5D-5L) questionnaires were used to assess medication adherence and HRQoL, respectively. Logistic regression analysis was employed to explore the relationship between participants' characteristics, medication adherence levels, and HRQoL impairment across the five dimensions of EQ-5D-5L. Statistical significance was set at p < 0.05.
Results:
A total of 300 patients were surveyed, of whom only 52.33% were adherent to their antihypertensive medication. Similarly, the mean (±SD) GMAS score of the participants was 25.21 (±6.5), and the mean (SD) EQ index and EQ-VAS scores were 0.84 ± 0.22 and 72.22 ± 11.67, respectively. The percentages of issues in various dimensions were 47.3% for mobility, 19.66% for self-care, 26.66% for usual activities, 70.33% for pain/discomfort, and 58% for anxiety/depression. Multiple logistic regression analysis revealed that higher education attainment, longer disease duration, and enrollment to health insurance schemes were significantly associated with improve patients' medication adherence (p < 0.05). Participants who were adherent to prescribed medication had lower odds of reporting problems with mobility (OR 0.21, 95% CI 0.11-0.39; p < 0.001), usual activities (OR 0.52, 95% CI 0.27-1.00; p = 0.05), pain (OR 0.17, 95% CI 0.08-0.32; p < 0.001), and anxiety (OR 0.36, 95% CI 021-0.62; p < 0.001).
Conclusions:
Medication adherence was suboptimal in substantial proportion of hypertensive patients. Adherence to medication was linked to an improved HRQoL in patients with hypertension regardless of sociodemographic and clinical variables.
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Errors occurring during blood pressure monitoring
Several factors...
Factors affecting Blood pressure
Physiological Factors:
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.