Medication Adherence and Perceived Family Support Among Elderly Patients with Hypertension Attending a Specialty Clinic in Lagos, Nigeria

GO Olaniran, B. Akodu, A. Olaniran, J. Bamidele, A. Ogunyemi, OO Idowu
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Abstract

Background: Hypertension and medication adherence are global public health challenges, with elderly patients suffering the most because they frequently have multiple co-morbidities. Objective: To evaluate the level of medication adherence and perceived family support among Nigerian elderly patients with hypertension. Methods: A descriptive, cross-sectional study among 293 consecutively consenting elderly hypertensive patients using an interviewer-administered, semi-structured questionnaire. The Modified Morisky Adherence Scale (MMAS-8) and Perceived Social Support-Family Scale (PSS-Fa) tools were used to assess medication adherence and perceived family support, respectively. Results: The mean age of respondents was 69.5±6.4 years. Medication adherence was good, moderate and poor among 14.3%, 68.6%, and 17.1% of the respondents respectively. Difficulty remembering to take medications was the primary reason for non-adherence in 73.7% of cases. Good adherence to medication was significantly associated with male gender (p = 0.046), living with grandchildren (p˂0.001), having other sources of income (p = 0.026) and receiving treatment for comorbid illnesses (p = 0.025). A higher proportion of the respondents (94.9%) had strong perceived family support, which lacked statistical significance regarding good medication adherence. (p = 0.739).  Conclusion: This study found medication adherence low, despite most participants' strong family support. Forgetfulness and financial constraints were the primary reasons for poor medication adherence. Although family support is highly recommended and beneficial for medication adherence, other comorbid and social factors should be considered.
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在尼日利亚拉各斯一家专科诊所就诊的老年高血压患者的药物依从性和感知的家庭支持
背景:高血压和药物依从性是全球公共卫生挑战,老年患者遭受的痛苦最大,因为他们经常有多种合并症。目的:评价尼日利亚老年高血压患者的药物依从性和感知家庭支持水平。方法:对293例连续同意的老年高血压患者进行描述性横断面研究,采用访谈者管理的半结构化问卷。使用改良Morisky依从性量表(MMAS-8)和感知社会支持-家庭量表(PSS-Fa)工具分别评估药物依从性和感知家庭支持。结果:调查对象平均年龄为69.5±6.4岁。14.3%、68.6%和17.1%的受访者认为药物依从性良好、中等和较差。在73.7%的病例中,难以记住服药是不遵守规定的主要原因。良好的药物依从性与男性(p = 0.046)、与孙辈一起生活(p小于0.001)、有其他收入来源(p = 0.026)和接受合并症治疗(p = 0.025)显著相关。有较高比例(94.9%)的受访者认为家庭支持较强,但在良好的药物依从性方面缺乏统计学意义。(p = 0.739)。结论:本研究发现药物依从性较低,尽管大多数参与者有强大的家庭支持。健忘和经济拮据是服药依从性差的主要原因。虽然强烈建议家庭支持并有利于药物依从性,但应考虑其他合并症和社会因素。
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