title: Barriers to and determinants of medication adherence among hypertensive patients attended National Health Service Hospital, Sunderland.
abstract: BACKGROUND
  Hypertension is a silent killer, a time bomb in both the developed and developing nations of the world. It is one of the most significant risk factors for cardiovascular morbidity and mortality resulting from target-organ damage to blood vessels in the heart, brain, kidney and eyes. Adherence to long-term therapy for chronic illnesses like hypertension is an important tool to enhance the effectiveness of pharmacotherapy.
  
  
  OBJECTIVE
  The two objectives of this study were to evaluate the extent and reasons of non-adherence in patients attended National Health Service (NHS) Hospital, Sunderland.
  
  
  METHODS
  The study was conducted for 4 months in the out-patient department of NHS Hospital. A total of 200 patients were selected randomly for this study. Morisky's Medication Adherence Scale was used to assess the adherence rate and the reason of non-adherence. Data were entered and analyzed using Microsoft Excel 2010.
  
  
  RESULTS
  The overall adherence rate was found to be 79% (n = 158). Adherence rate in females were low was compared with their male counterparts (74.7% vs. 85.7%). The higher rate of adherence was found in age group of 30-40 years (82%, n = 64). The major intentional and non-intentional reason of non-adherence was side-effects and forgetfulness respectively.
  
  
  CONCLUSIONS
  Overall, more than three-fourth of the hypertensive participants were found to be adherent to their treatment. On the basis of factors associated with non-adherence, it is analyzed that suitable therapy must be designed for patients individually to increase medication adherence and its effectiveness.
authors.affiliation: College of Pharmacy, Ziauddin University, 4-B Shahra e Ghalib, Clifton, Karachi, Pakistan.
authors.forename: Muhammad Umair
authors.initials: MU
authors.lastname: Khan
authors.affiliation: Department of Pharmacy Services, Dr. Sulaiman Al Habib Hospital, Buraidah, Qassim, Saudi Arabia.
authors.forename: Shahjahan
authors.initials: S
authors.lastname: Shah
authors.affiliation: Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, Tyne and Wear, UK.
authors.forename: Tahir
authors.initials: T
authors.lastname: Hameed
keywords: Adherence; barriers; hypertension
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