Qualitative enquiry on irregular intake of antihypertensive medications to inform a model of care to improve blood pressure control

Abstract

Background: A large proportion of people with hypertension do not take medications regularly. There is little understanding of this complex behaviour in India. Methods: A descriptive qualitative study was conducted in two districts of Andhra Pradesh, India, to explore the reasons for irregular intake of anti-hypertensive drugs from patient’s and health care provider’s (HCP) perspectives. In-depth interviews and focus group discussions were carried out among HCPs and patients with irregular drug intake. Results: The major themes that emerged were: (i) patient’s perception of immediate relief and poor awareness about the disease, (ii) patient’s misconceptions about the drug and fear of life long medications, (iii) busy schedule and forgetfulness, (iv) health system factors such as lack of patient counselling, high cost of care and non-availability of medicines, and (v) lack of peer/family/social support and social stigma. Conclusion: Better patient education and counselling services and active engagement of family members and peers are needed to improve medication adherence. The NPCDCS program should implement mechanisms to assess and monitor adherence to medications in chronic diseases particularly for hypertension. Impact: Currently there is no strategy to ensure medication adherence in India. The results of the study will be utilized in developing a community model of care to improve the level of adherence and better control of blood pressure. KEYWORDS: hypertension; medication adherence; compliance; qualitative study