Predictors of nonadherence to antihypertensive medications among hypertensive adults in Delhi: A community-based cross-sectional study

ABSTRACT Context: Hypertension affects nearly a quarter of adults in India. While there are issues related to diagnosis and treatment gaps, even among those who receive treatment, adherence is a problem resulting in poor control. Aims: To identify predictors of nonadherence to antihypertensive medications among hypertensive adults in Delhi. Settings and Design: A community-based cross-sectional study was conducted in the Palam area of Southwest Delhi, the field practice area of the Department of Community Medicine, Lady Hardinge Medical College. Materials and Methods: Systematic random sampling was done to enroll 322 study participants. A semi-structured, pretested questionnaire was used to collect data, and Morisky’s Medication Adherence Scale, consisting of eight items, was used to assess adherence to medication. Participants who scored <8 on an 8-item Morisky Medication Adherence Scale were considered nonadherent, and those with a score of 8 were considered adherent. Statistical Analysis Used: IBM Statistical Package for the Social Sciences, version 25 for cleaning and analysis. Quantitative data were expressed in terms of mean and standard deviation. Qualitative data were expressed as proportions, and the chi-square test was applied to calculate statistical significance. Univariate and multivariable analyses were conducted to identify the predictors of nonadherence. P- value < 0.05 was considered statistically significant. Results: Nonadherence to antihypertensive medications was 74.3% (95% confidence interval [CI]: 69.7%–79.3%). Symptomatic patients had significantly higher odds of nonadherence (adjusted odds ratio [AOR] = 2.63; 95% CI: 1.40–4.96; P = 0.003). Patients with comorbidities were found to have significantly lower odds of nonadherence (AOR = 0.22; 95% CI: 0.11–0.43; P < 0.001). Conclusions: Nonadherence to antihypertensive medication was found to be high. Being symptomatic was associated with more nonadherence. Having comorbidities was associated with less nonadherence. Targeted interventions are needed to improve adherence in these groups.