Abstract

Research Article

Compliance of hypertensive patients with antihypertensive drug therapy at the Renaissance Hospital of N’Djamena, Chad

Adam Ahamat Ali*, Guillaume Mahamat Abderraman*, Zeinabou Maiga Moussa Tondi and Hissein Ali Mahamat

Published: 23 October, 2019 | Volume 3 - Issue 1 | Pages: 047-051

Introduction: High blood pressure is a major cardiovascular risk factor. In hypertension, non-compliance is frequent. The objective of this work is to evaluate the therapeutic observances and to identify the predictive factors of poor compliances in Chadian hypertensive patients.

Patients and Methods: It was a prospective cross-sectional study over a six-month period from January 15 to July 15, 2019. This was performed in the outpatient Cardiology and Nephrology units at the Renaissance Hospital of N’Djamena. We included all follow-up patients who had hypertension who consulted during the study period. However, dialysis patients and children were excluded from this study. The parameters studied were demographic characteristics, economic and therapeutic data and the rate of therapeutic compliance.

Results: Eighty-seven patients were included. The average age was 50 years old. The sex ratio was 2.5. Sixty-seven percent (n = 58) of the patients were from urban areas. The predominant cardiovascular risk factors were smoking in 25% (n = 22) and diabetes in 23% (n = 20). Hypertension was uncontrolled in 76% (n = 66) patients. Adherence was poor in 66% (n = 57) of patients. The monthly cost of treatment was respectively 10,000 and 20,000 FCFA in 52% (n = 45) of cases. Combination therapy was observed in 70% of cases (n = 61) and 56% (n = 49) of patients had more than one drug intake. The adherence rate was 93% (n = 28) in the urban population (p < 0.001). All patients (n = 30) who were observing their treatment were educated (p < 0.001). The adherence rate was 20% (n = 6) in patients who had a monthly income less than 100,000 FCFA (p = 0.004). The adherence rate was 60% (n = 18) when the monthly cost was less than FCFA 10,000 (p = 0.003). The adherence rate was 77% (n = 23) in patients receiving monotherapy (p < 0.001).

Conclusion: This study showed a low level of adherence in Chadian hypertensive patients. The complexity and cost of antihypertensive therapy, poor knowledge of hypertension, and ignorance of its severity have been the main factors of poor compliance.

Read Full Article HTML DOI: 10.29328/journal.ach.1001019 Cite this Article Read Full Article PDF

Keywords:

Arterial hypertension; Therapeutic observance; N’Djamena-Chad

References

  1. Chamontin B, Poggi L, Lang T, Menard J, Chevalier H, et al. Prevalence, treatment, and control of hypertension in the French population: data from a survey on high blood pressure in general practice, 1994. Am J Hypertens. 1998; 11: 759-762. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9657642
  2. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005; 353: 487-497. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16079372
  3. Ho PM, Bryson CL, Rumsfeld JS. Medication adherence: its importance in cardiovascular outcomes. Circulation. 2009; 119: 3028-3035. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19528344
  4. Piquet V, Cedrashi C, Desmeules J. Prescription médicamenteuse: les attentes des patients. Med Et Hyg. 2000; 58: 814-817.
  5. Giraud M. Observance thérapeutique et rôle infirmier. Rev De l’Infirmiére. 1999; 52: 48-49.
  6. Bertrand Ed. Le Dogme et réalité; la pathologie cardiovasculaire en pays sous développé cardiol Trop. 1988; 14: 95-96.
  7. Cohen A. Cardiologie et pathologie vasculaire Ed. ESTEM. Paris. 1997: 188-192.
  8. Chowdhury R, Khan H, Heydon E, Shroufi A, Fahimi S, et al. Adherence to cardiovascular therapy: a meta-analysis of prevalence and clinical consequences. Eur Heart J. 2013; 34: 2940–2948. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23907142
  9. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, et al. The seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure. JAMA. 2003; 289: 2560-2572. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12748199
  10. Girerd X, Hanon O, Anangnostopoulos K, Cirepek L, Mourad JJ, et al. Evaluation de l'observance du traitement antihypertenseur par un questionnaire : mise au point et utilisation dans un service spécialisé. Presse Med. 2001; 30: 1044-1048.
  11. Williams B, Mancia G, Spierin GW, Agabiti Rosei E, Azizi M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39: 3021-3104. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30165516
  12. Claxton A, Cramer JA, Pierce C. A systematic review of associations between dose regime and medication compliance. Clin Ther. 2001; 23: 1296-1310. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11558866
  13. Iskedjian M, Einarson TR, Mackeigan LD, Shear N, Addis A, et al. Relation between daily frequency and adherence to antihypertensive pharmacotherapy: evidence from a meta-analysis. Clin Ther. 2002; 24: 302-316. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11911560
  14. Konin C, Adoh M, Coulibaly I, Kramoh E, Safou M, et al. Observance thérapeutique et ses facteurs chez l’hypertendu noir africain. Archives des maladies du coeur et des vaisseaux Vol 100, N° 8 - août 2007; 630-634.
  15. Ghozzi H, Kassis M, Hakim A, Sahnoun Z, Abderrahmen A, et al. Observance médicamenteuse chez un échantillon d'hypertendus dans la région de Sfax (Tunisie). Ann Cardiol Angeiol. 2010; 59: 131-137.
  16. Stéphane IM, Nsitou BM, Loumouamou M, Kimbally-Kaky G, Nkoua JL. L’observance médicamenteuse et ses facteurs dans un groupe d’hypertendus congolais. Pan Afr Med J. 2013; 15: 121.
  17. Gallup G Jr, Cotugno HE. Preferences and practices of americans andtheir physicians in antihypertensive therapy. Am J Med. 1986; 81: 20-24. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2879454
  18. Adoubi KA, Diby KF, Nguetta R, Yangni-Angate KH, Adoh AM. Facteurs de la mauvaise observance thérapeutique de l'hypertendu en Côte d'Ivoire. Rev Int Sc Med. 2006; 8: 18-22.
  19. Pio M, Baragou S, Afassinou Y, Pessinaba S, Atta B, et al. Observance thérapeutique de l’hypertension artérielle et ses facteurs dans le service de cardiologie du CHU Tokoin de Lomé. Pan Afr Med J. 2013; 14: 48.
  20. Eisen SA, Miller DK, Woodwards RS, Spitznagel E, Przybeck TR. The Effect of Prescribed Daily Dose Frequency on Patient Medication Compliance. Arch Intern Med. 1990; 150: 1881-1884. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2102668
  21. Saounatsou M, Patsi O, Fasoi G, Stylianou M, Kavga A, et al. The influence of the hypertensive patients education in compliance with their medication. Public Health Nurs. 2001; 18: 436-442. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11737812
  22. Campbell NR, Lackland DT, Lisheng L, Zhang XH, Nilsson PM, et al. The World Hypertension League: where now and where to in salt reduction. Cardiovasc Diagn Ther. 2015; 5: 238-242. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26090335
  23. Pio M, Baragou S, Afassinou Y, Pessinaba S, Atta B, et al. Observance thérapeutique de l'hypertension artérielle et ses facteurs dans le service de cardiologie du CHU Tokoin de Lomé. PAMJ. 2013; 14: 48.
  24. Perreault S, Lamarre D, Blais L, Dragomir A, Berbiche D, et al. Persistence with treatment in newly treated middle-aged patients with essential hypertension. Ann Pharmcother. 2005; 39: 1401-1408. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16076920

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