The assessment of adherence of hypertensive individuals to treatment and lifestyle change recommendations.
OBJECTIVE
Most of studies about adherence in hypertension highlight the adherence to the medical treatment but do not include the adherence to the other recommendations, such as lifestyle modifications. The factors effective on adherence to each type of recommendation may differ. Accordingly, we aimed in this study to show that nonadherence to each recommendation should be assessed individually.


METHODS
The study, which was designed as cross-sectional and descriptive, included 150 patients who were followed by the outpatient clinics for at least one year. A data collecting form with 44 questions was prepared by the investigators, and the patient adherence was assessed in five categories: medicine-related adherence, diet-related adherence, exercise-related adherence, measurement-related adherence and smoking related adherence. The face-to-face interview method was used to collect data. Statistical analysis was accomplished by Chi-square test and logistic regression analysis.


RESULTS
Of 150 subjects included in the study, 94 (63%) were female and mean age was 56+/- 12 (20-81) years. Mean duration of drug use was 6.5+/- 6.5 years and the mean number of drugs used was 1.6+/- 0.8. The adherence to recommendations of medication, diet, exercise, home-blood measurement and smoking were 72%, 65%, 31% , 63% and 83%, respectively. Each patient was adherent to at least one recommendation, while 11% of patients were adherent to one recommendation, 23% - to two, 29% - to three, 24% - to four and 13% - to five. According to the regression analysis, factors effective on each type of adherence were found to be different from others. The presence of three or more types of adherence was related to income level (OR= 0.297; 95%CI - 0.132-0.666; <0.001) and presence of any other chronic disease (OR=2.329; 95% CI - 1.114-4.859; p=0.002).


CONCLUSIONS
The rates of adherence to medicine and life-style changes were generally found to be low in hypertension. The cause of nonadherence is different according to the type of adherence. Each recommendation should be assessed individually in terms of adherence.
School of Nursing, Gülhane Military Medical Academy, Ankara, Turkey. senuzun@yahoo.com
Senay
S
Uzun
Belgüzar
B
Kara
Mehmet
M
Yokuşoğlu
Filiz
F
Arslan
Mehmet Birhan
MB
Yilmaz
Hayrettin
H
Karaeren
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D018660:Blood Pressure Monitoring, Ambulatory; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004522:Educational Status; D015444:Exercise; D005260:Female; D006801:Humans; D006973:Hypertension / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D007182:Income; D007407:Interviews as Topic; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010349:Patient Compliance; D010353:Patient Education as Topic; D016540:Smoking Cessation; D013997:Time Factors; D014421:Turkey; D055815:Young Adult
D000959:Antihypertensive Agents