title: Adherence to Antihypertensive Medications: Population Based Follow up in Eastern Nepal.
abstract: BACKGROUND
  Poor adherence toward antihypertensive drugs is a worldwide problem that results in poor health outcomes and increased health care costs. Community based study related to adherence to antihypertensive medication is limited in context of Nepal.
  
  
  METHODS
  This study was conducted to explore the extent of adherence towards prescribed antihypertensive treatment and to identify the factors of non adherence. Community based cross sectional study was conducted in Dharan Municipality of Eastern Region of Nepal from September 2009 to February 2010. Out of 975 hypertensive patients, 154 calculated samples were selected following simple random sampling method. Data was collected by interview method and adherence was measured by using four items Morisky Medicine adherence scale. Data was analyzed using SPSS by descriptive and inferential (Chi square and logistic regression analysis) Statistical method.
  
  
  RESULTS
  Among the 154 hypertensive patients, only 56.5% patients were adherent to antihypertensive medication. The important predictors of non adherence by logistic regression analysis at 95% Confidence Interval were illiteracy (OR 5.34, CI= 1.23 -23 , P=0.025), expensive price of medicine (OR 5.14, CI=1.1-23.9, P=0.037), missed medicine due to cost (OR 0.143,CI=0.02-0.78, P= 0.025), no family history of hypertension (OR 4.46,CI= 1.21-16.4, P=0.024), irregular follow up (OR 6.39,CI=1.22-33.3, P=0.028), more than one pills per day ( OR 5.33,CI=1.19-23.7, P= 0.028).
  
  
  CONCLUSIONS
  Around half of the population was non adherent towards antihypertensive medications so identified gap need to be addressed to increase adherence level.
authors.affiliation: Kathmandu Medical College, Kathmandu, Nepal.
authors.forename: B
authors.initials: B
authors.lastname: Bhandari
authors.affiliation: National Academy of Medical Science, Bir Hospital, Kathmandu, Nepal.
authors.forename: M
authors.initials: M
authors.lastname: Bhattarai
authors.affiliation: Sunsari District Hospital, Inarwa, Sunsari, Nepal.
authors.forename: M
authors.initials: M
authors.lastname: Bhandari
authors.affiliation: School of public health and community medicine,B.P. Koirala Institue of Health Sciences, Dharan, Nepal.
authors.forename: A
authors.initials: A
authors.lastname: Ghimire
authors.affiliation: School of public health and community medicine,B.P. Koirala Institue of Health Sciences, Dharan, Nepal.
authors.forename: P K
authors.initials: PK
authors.lastname: Pokharel
authors.affiliation: UCLA Schools of Public Health, Los Angles, California, USA.
authors.forename: D E
authors.initials: DE
authors.lastname: Morisky
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009390:Nepal; D011306:Prescription Fees; D012959:Socioeconomic Factors; D016903:Drug Monitoring
chemical_list: D000959:Antihypertensive Agents
keywords: Adherence; hypertension; medication.