Predictors of adherence to prescribed antihypertensive medications among Hypertensive (15-49 years) in India: A secondary data analysis of National Family Health Survey 4.

Abstract

Adherence to medications is one of the key determinants of therapeutic control of high blood pressure and is seen as a bottleneck in our fight against hypertension control. We have little scientific evidence from India that highlights the determinants of treatment adherence. The purpose of this study was to identify the predictor adherence to the currently prescribed antihypertensive medications. We did a secondary data analysis of the National Family Health Survey, 2015-2016 datasets. As there were no direct variables to measure adherence, this was derived from the responses to the survey question: "currently taking a prescribed hypertensive medication to lower Blood Pressure" among those already diagnosed as hypertensives by the physician. The other sociodemographic and household-level variables were used as independent variables for analysis. The level of awareness about their hypertensive status among the 15-49-year-olds who were subjected to blood pressure measurement was 9.34% (70,267/80,3081). Of these, 70,267 participants, 65878 with valid hypertensive individual data were included in the final analysis. Among them, 26.78% are currently adhering to antihypertensive medication. Female gender (adj OR; 95% CI: 1.17 [1.09-1.24]) and non-reserved caste ([OR] 1.24; 95% [CI]: 1.18-1.32) depicted better adherence to the current treatment. The hypertensives who preferred taking treatment from shops or at home or some other place in comparison to health facilities had a significant association with adherence (adj OR: 1.64; 95% CI: [1.43-1.88]). The current study reported low adherence to the current antihypertensive medication. Gender, higher age group, obesity, and place of taking the treatment were strongly associated with adherence to treatment.