An assessment of treatment compliance using the Morisky scale-8 tool in adult hypertensive patients of Eastern India

Raman Kishor; Sarita Kumari; Ravi Prakash; Neha Chaudhary; Shyama Shyama; Shamshad Ahmad; Pragya Kumar

doi:10.4103/jfmpc.jfmpc_1416_23

An assessment of treatment compliance using the Morisky scale-8 tool in adult hypertensive patients of Eastern India

J Family Med Prim Care. 2024 Mar;13(3):924-931. doi: 10.4103/jfmpc.jfmpc_1416_23. Epub 2024 Apr 4.

Authors

Raman Kishor¹, Sarita Kumari², Ravi Prakash¹, Neha Chaudhary¹, Shyama Shyama³, Shamshad Ahmad², Pragya Kumar²

Affiliations

¹ Department of Community Medicine, ESICMCH, Patna, Bihar, India.
² Department of Community and Family Medicine, AIIMS, Patna, Bihar, India.
³ Department of General Medicine, AIIMS, Patna, Bihar, India.

Abstract

Background: Adequate management of hypertension is crucial for decreasing the likelihood of cardiovascular ailments and associated complications. Nonetheless, in the Indian context, maintaining compliance with prescribed hypertensive therapies presents a notable hurdle, impeding the attainment of favorable health outcomes. Thus, this study was conducted with the aim to evaluate the prevalence of treatment adherence and explore the diverse factors that impact adherence patterns among individuals diagnosed with hypertension.

Material and methods: A community-based cross-sectional questionnaire-based study was carried out among the diagnosed hypertensive patients from 12 purposefully selected villages of Khagaul block, Patna. A total of 262 participants were recruited in the study by using non-probability sampling. The 8-item Morisky Medication Adherence Scale (MMAS-8) was used for measuring adherence. The Statistical Package for the Social Sciences (SPSS) for Windows version 21.0 (SPSS Inc; Chicago, IL, USA) was used for statistical analysis of data.

Result: As per MMAS scores, 10 (3.8%) had high, 133 (50.8%) moderate, and 119 (45.4%) poor adherence. However, good adherence was reported among geriatric patients [1.65 (1.01-2.7)], those with a history of absence of comorbidities [2.15 (1.21-3.85)], more than 5 years' duration of hypertension [3.2 (1.89-5.41)], once-a-day drug intake [2.8 (1.61-4.87)], and having controlled blood pressure [5.2 (3.08-8.96)]. Controlled blood pressure (AOR = 0.048, 0.023-0.098), perception of high benefit of treatment [0.497 (0.255-0.97)], and absence of comorbidity [0.016 (0.168-0.832)] were identified as predictors of good treatment adherence.

Conclusion: Overall medication adherence in the current study was 54.6%. Achieving treatment adherence frequently demands proactive patient engagement, highlighting their active role in disease management. Also, involving the patient's caregivers can offer an additional tactic to tackle non-adherence stemming from forgetfulness of the patient.

Keywords: Blood pressure control; Morisky adherence scale; compliance; hypertension; self-reported adherence; treatment adherence.