Abstract

Background: Hypertension is a global health issue among the adult population with high morbidity and mortality rates. As the case detection rate of hypertension increases in adult Nigerians, achieving goal blood pressure (BP) control has become an important management challenge due to poor adherence to medication.

Objective: To determine the role of patient education in medication adherence amongst adult Nigerians with primary hypertension attending primary care clinic of tertiary hospitals in Ekiti State.

Methods: Quasi-experimental study was carried out in 580 adult patients (290 in intervention and 290 in control group) with primary hypertension who had been on treatment for at least 6 months. Relevant data were collected using interviewer administered semi-structured questionnaire. Participants in intervention group received education sessions about hypertension and medication adherence at every clinic visit in a structured and individualised format. The control group was routinely monitored.

Results: The difference in the mean knowledge score in the intervention group increased to a statistically significant level (p < 0.05), from 9.5 ± 2.8 to 10.9 ± 3.0. An increase of 8.7 (p = 0.000) in mean adherence score was found in the intervention group after the education sessions while a marginal difference of 0.2 (p = 0.059) was found in the control group. Mean knowledge score and adherence to medication of subjects in intervention group showed a significant increase compared to those of the control group. Knowledge, adherence status and blood pressure control were significantly different between the two groups (p < 0.05) at the end of the study.

Conclusion: Good knowledge about hypertension as a result of clinician educating patients is linked to better medication adherence and ultimately improved BP control. Primary care Physicians will do well to educate hypertensive patients with a view to improving medication adherence in them.

Keywords: Medication Adherence; Patient Education; Blood Pressure; Intervention; Hypertension

References

1. Saman KH., et al. “Factors associated with adherence to antihypertensive treatment in Parkistans”. PLoS One3 (2007): e280.
2. Kearney PM., et al. “Global burden of hypertension: analysis of worldwide data”. Lancet 365 (2005): 217-223.
3. Uzun S., et al. “The assessment of adherence of hypertensive individuals to treatment and lifestyle change recommendations”. Anadolu Kardiyol Derg 9 (2009): 102-109.
4. Inkster ME., et al. “Adherence to antihypertensive medication and association with patient and practice factors”. Journal of Human Hypertension 20 (2006): 295-297.
5. Falaschetti E. “Blood pressure”. Health Survey for England (2004): 181-220.
6. Iloh GUP., et al. “Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria”. African Journal of Primary Health Care and Family Medicine1 (2013): 123-126.
7. Omuemu VO., et al. “Awareness of high blood pressure status, treatment and control in a rural community in Edo State”. Nigerian Journal of Clinical Practice 10 (2007): 208-212.
8. Katibi IA., et al. “Knowledge and practice of hypertensive patients as seen in a tertiary hospital in the middle belt of Nigeria”. Nigerian Journal of Clinical Practice 13 (2010): 159-162.
9. Sani MU., et al. “Blood pressure control among treated hypertensives in a tertiary health institution”. Nigerian Journal of Clinical Practice 17 (2008): 270-274.
10. Maiyaki MB and Garbati MA. “The burden of non-communicable diseases in Nigeria in the context of globalization”. Annals of African Medicine 1 (2014): 1-10.
11. Adebisi OO and Samali A. “Poverty and hypertension in Nigerian adults: A barrier to its control and treatment. A review”. Unique Research Journal of Medical Sciences 3 (2013): 14-20.
12. Ganiyu KA and Suleiman IA. “Economic burden of drug therapy in hypertension management in a private Teaching Hospital in Nigeria”. British Journal of Pharmaceutical Research 1 (2014): 70-78.
13. Chobanian AU., et al. “Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure”. Journal of the American Medical Association 289 (2003): 2560-2572.
14. Visser A., et al. “Patient education and counseling Editorial”. Patient Education and Counseling 3 (2008): 357-358.
15. Hamers JP., et al. “Editorial. Changing patient education”. Patient Education and Counseling 78.3 (2010): 273-274.
16. Busari OA., et al. “Impact of patients’ knowledge, attitude and practices on Hypertension on Compliance with Antihypertensive drugs in a Resource-poor setting”. TAV Preventive Medicine Bulletin 2 (2010): 87-92.
17. Ahaneku GI., et al. “Evaluation of blood pressure and indices of Obesity in a typical rural community in eastern Nigeria”. Annals of African Medicine 10 (2011): 120-126.
18. Hacihasaoglu R and Gozum S. “The effect of patient education and home monitoring on medication compliance, hypertension, management, healthy lifestyle behaviours and BMI in a primary health care setting”. Journal of Clinical Nursing 5-6 (2011): 692-705.
19. Asekun-Olarinmoye EO., et al. “Prevalence of hypertension in the rural adult population of Osun State, southwestern Nigeria”. International Journal of General Medicine 6 (2013): 317-322.
20. Saleem F., et al. “Association between Knowledge and Drug adherence in patients with Hypertension in Quetta, Pakistan”. Tropical Journal of Pharmaceutical Research2 (2011): 125-132.
21. Morisky DE., et al. “Concurrent and predictive validity of a self-reported measure of medication adherence”. Medical Care1 (1986): 67-74.
22. Amal S., et al. “Hospital admission and poor adherence to antihypertensive therapy: Is there any relationship? ” Int Journal of Pharmacy and Pharmaceutical Sciences1 (2009): 38-46.
23. Kabir M., et al. “Compliance to medication among hypertensive patients in Murtala Mohammed Specialist Hospital, Kano, Nigeria”. Journal of Community Medicine and Primary Health Care1 (2004): 16-20.
24. Akpa MR., et al. “Drug compliance among hypertensive patients in Port Harcourt, Nigeria”. Nigerian Journal of Medicine 14 (2005): 55-57.
25. Busari A., et al. “Educational Intervention as a Strategy for Improving Blood Pressure Status of market Women in Lagos, Nigeria”. The Internet Journal of Health1 (2010).
26. Ogah SO., et al. “Blood pressure, prevalence of hypertension and hypertension related complications in Nigerian Africans: A review”. World Journal of Cardiology12 (2012): 327-340.
27. Ordinioha B. “The prevalence of hypertension and its modifiable risk factors among lecturers of a medical school in Port Harcourt, south-south Nigeria: Implications for control effort”. Nigerian Journal of Clinical Practice1 (2013): 1-4.
28. Karaeren H., et al. “The effect of the content of the knowledge on adherence to medication in hypertensive patients”. Anadolu Kardiyol Derg 9 (2009): 183-188.
29. Reckelhoff JF. “Gender Differences in the Regulation of Blood Pressure”. Hypertension 37 (2001): 1199-1208.
30. Shawand BH and Protheroe CL. “Sex, drugs and blood pressure control: the impact of age and gender on sympathetic regulation of arterial pressure”. The Journal of Physiology 12 (2012): 2841-2843.
31. Ambaw DA., et al. “Adherence to antihypertensive treatment and associated factors among patients on follow up at University of Gondor Hospital, Northwest Ethiopia”. BMC Public Health 12 (2012): 282.
32. Almas A., et al. “Good knowledge about hypertension is linked to better control of hypertension A multicentre cross sectional study in Karachi, Pakistan”. BMC Research Notes 5 (2012): 579.
33. Kim EY., et al. “Does knowledge matter? Intentional medication non-adherence among middle-aged Korean Americans with high blood pressure”. Journal of Cardiovascular Nursing 5 (2007): 397-404.
34. Casson RI., et al. “Markers of loss of control of hypertension”. Canadian Family Physician 49 (2003): 1323-1331.
35. Morris AB., et al. “Factors associated with drug adherence and blood pressure control in patients with hypertension”. Pharmacotherapy4 (2006): 483-492.
36. DiMatteo MR., et al. “Patient adherence and medical treatment outcomes: a meta-analysis”. Medical Care 9 (2002): 794-811.

Citation

Citation: Ayodapo AO., et al. “Patient Education and Medication Adherence: A Quasi-Experimental Study in Tertiary Hospitals Southwestern Nigeria". Acta Scientific Medical Sciences 4.6 (2020): 37-44.

Copyright

Copyright: © 2020 Ayodapo AO., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.