Assessment of Antihypertensive Medication Adherence in a Rural Indian Population

Abstract

Background: Hypertension is a leading non-communicable disease and a major contributor to cardiovascular morbidity and mortality in India. Medication adherence plays a crucial role in achieving optimal blood pressure control; however, adherence remains suboptimal, particularly in rural populations due to various socioeconomic and healthcare-related barriers. This study aimed to assess antihypertensive medication adherence and identify factors associated with adherence in a rural population.
Methods: A community-based cross-sectional study was conducted among 366 hypertensive patients aged ≥18 years residing in the rural locality around the Primary Health Center of Medavakkam, Chennai. Participants with a diagnosis of hypertension for more than one year were included. Medication adherence was assessed using the Morisky Medication Adherence Scale-8 (MMAS-8). Sociodemographic and clinical data were collected through door-to-door surveys using a structured questionnaire. Data were analyzed using SPSS version 24. Descriptive statistics were used to summarize variables, and the Chi-square test and ANOVA were applied to assess associations between adherence and independent variables. A p-value <0.05 was considered statistically significant.
Results: Among the 366 participants, 28.1% demonstrated high adherence, 50.5% showed medium adherence, and 21.3% had low adherence to antihypertensive medication. Female participants exhibited significantly higher adherence compared to males (p = 0.01). Patients receiving fewer antihypertensive medications had better adherence than those on multiple medications (p = 0.04). Age showed a borderline association with adherence (p = 0.07), while education level, occupation, and duration of hypertension were not significantly associated with adherence.
Conclusion: The study found that a substantial proportion of hypertensive patients in this rural population exhibited only moderate adherence to antihypertensive therapy. Gender and medication regimen complexity were significant determinants of adherence. These findings highlight the need for targeted interventions such as patient education, simplified treatment regimens, and community-based strategies to improve medication adherence and strengthen hypertension management in rural settings.