IMPROVING ADHERENCE TO ANTIHYPERTENSIVE MEDICATIONS WITH EDUCATIONAL INTERVENTION

Abstract

Hypertension awareness, treatment and control are relatively low in Nigeria, thus its continuous rise in incidence. Adherence to therapy is the mainstay of the success of treatment regimens. Interventions to improve treatment adherence and subsequent positive outcomes are recommended worldwide. An educational intervention study was carried out in two tertiary health facilities (FMC and NDUTH) in Bayelsa State, Nigeria. A convenient sampling technique was adopted. Trained Pharmacist interviewed willing hypertensive patients between 21-80 years of age at the clinic using an adapted modified form of the Morisky Medication Adherence Scale (MMAS-8). Demographic characteristics were also recorded. The responses (425) were analyzed and observed. Interactive health talk to educate patients was then carried out on weekly cardiology clinic days for 6 weeks. The questionnaire was re-administered after two months and responses (297) were analyzed in like manner. The results of post intervention phase were compared with that of pre intervention for possible significant differences. Low but increasing adherence scores (4.74 to 5.21 FMC; 4.87 to 5.67 NDUTH) pre and post intervention were reported in the study. Being married, living with an adult, education above secondary school and being employed were reported to enhance adherence. Goal BP increments (preR² = 0.75, postR² = 0.505 FMC; and preR² = 0.723, postR² = 0.910 NDUTH) were also in tandems with the adherence increments. Educational intervention brought about a modest improvement in adherence, a significant improvement in performance of all psychometric measures of the instrument and a tandem goal BP increment. Marriage, companionship, education and employment were factors that positively impacted adherence.