Assessment of compliance to treatment of hypertension and diabetes among previously diagnosed patients in urban slums of Belapur, Navi Mumbai, India

• Main Authors: Sneha Pratap Kotian, Prasad Waingankar, Virendra J Mahadik
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Indian Journal of Public Health
• Subjects: diabetes; hypertension; medication adherence
• Online Access: http://www.ijph.in/article.asp?issn=0019-557X;year=2019;volume=63;issue=4;spage=348;epage=352;aulast=Kotian

Background: Nonadherence to treatment is a challenge in managing the increasing burden of chronic noncommunicable diseases in India. The issue is not limited only to people having limited access to health-care services, but for a variety of reasons, a typical pattern of nonadherence is being seen. Objective: The objective was to assess the compliance and to find out the reasons of noncompliance to treatment of diabetes/hypertension among previously diagnosed patients from urban slums. Methods: This is a community-based, cross-sectional study conducted during October 2017–February 2018 in urban slums of Belapur, Navi Mumbai, selecting all cases of diabetes and hypertension diagnosed for >1 year by house-to-house survey, covering a population of 4125. A structured and pretested questionnaire including sociodemographic details, treatment details, and compliance pattern was administered. Results: The study included 208 individuals, of which 164 were under treatment for hypertension and 85 for diabetes. All the patients revealed discontinuation of medication for a significant period at some point since diagnosis. The most common reasons of noncompliance were lack of money (50.58% patients with diabetes, 73.78% patients with hypertension) and difficulty to remember to take daily medication due to work or forgetfulness (49.41% patients with diabetes, 26.21% patients with hypertension). Only 56.5% of patients with diabetes and 64.6% of patients with hypertension were aware that discontinuation of treatment can cause complications, whereas 95.3% of patients with diabetes and 99.4% of patients with hypertension feel that remembering medication at work is difficult. Conclusions: As the nonadherence is too high, there is an urgent need of attention to this aspect, and remedial measures such as proper counseling to the patient, involvement of family members, and use of low-cost drugs for treatment should be sought.