A16175 Barriers to Blood Pressure Control and Treatment Adherence in Hypertensive Management: An Observational Study in Resource-Poor Setting Hospital

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Abstract

Objectives:

Hypertension is the major driver of the cardiovascular epidemic facing Indonesia in the 21st century. In resource-poor settings, reasons for inadequate control of hypertension are heterogeneous and include low adherence to anti-hypertension medication or low compliance with scheduled follow-up visits. Penawar Medika Hospital (PMH) is located in Tulang Bawang-a remote area 372 kms away from the capital city of Indonesia. At present very little is known about hypertension treatment and blood pressure control among hypertensive patients in this area. The aim of this study was to investigate hypertension treatment and control in a hospital setting in Tulang Bawang.

Methods:

This descriptive study used data collected from medical records of hypertensive patients in Outpatient Department of PMH between 1 January 2017 to 31 December 2017.

Results:

There were 160 patients. Their mean age was 55.58 ± 12.61 years old. Patient diagnosed in the first visit as having hypertension stage 1 were 30.6% while hypertension stage 2 were 69.4 %. Patients receiving monotherapy was 69.4% and the rest received combination therapy. Only 13% of these patients complied with their scheduled follow up visits and only 9.4% could achieve targeted blood pressure. Receiving combination therapy was the strongest predictor of poor treatment compliance (OR = 1,173, p = 0.039, 95% CI:0.998–1.379) while higher stage of hypertension, i.e, patients with Hypertension Stage 2, was the predictor of poor control of blood pressure (OR = 1,121, p = 0.039, 95% CI:1,033–1,216)

Conclusion:

Treatment compliance and control of blood pressure are extremely low in this setting. Efforts should be made to improve assessment of hypertensive patients, optimise antihypertensive therapy and promote patient adherence to treatment.

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