A0471 COMPLIANCE AND COMPLICATIONS OF HYPERTENSION TREATMENT AMONG LIFESTYLE CLINIC PATIENTS, JODHPUR, INDIA

Objectives: To study the treatment compliance and adverse effects among hypertensive patients receiving treatment at NCD clinic, UHTC Pratap Nagar, Jodhpur, India. Methods: A longitudinal cohort study was conducted on 1036 hypertensive patients enrolled at NCD clinic, Pratap Nagar, Jodhpur, India. Patients attendees to clinic during inception (Nov, 2013) were selected for study purpose and quarterly follow-ups were done. The participants were asked about their socio-demographic status, therapy, side effects, and compliance with physicians’ instructions. In addition, 8 physicians reported: prescribing practices, drug side effects, and patient compliance for data corroboration. Non compliance was defined as a ≥2-point decrease on the 8-item Morisky Medication Adherence Scale assessed during follow-ups after baseline. Multivariate regression analysis was done with P < 0.05 considered significant for variable effect under study. Results: We observed an attrition rate of 9.2% (n = 96).61.9% hypertensives for above 10 years, and 48.0% were on multiple drug therapy. Over the 2 years of follow-up, 32.2% participants were non compliant to treatment. After multivariate adjustment non compliance was significantly associated with: age (>60yrs, p = 0.003), uncontrolled BP (p = 0.025), illiteracy (p = 0.041), lower SES (p < 0.01) and adverse effect (p < 0.001). Drug adverse effects were reported among 19.01% participants; most frequently observed were dizziness (56.8%), cough (44.6%), oedema (28.4%) and rash/itch (17.7). Important predictors for changed therapy (41.21%) status were inadequate BP control (68.9%), adverse effects (11.9%), service dissatisfaction (7.0%) and cost (4.9%) etc. Conclusion: Poor adherence to treatment is common in hypertensives mostly due to dissatisfaction to treatment & services and adverse effects.