Adherence-related challenges and drug utilization in hypertension management

Abstract

Arterial hypertension is a major contributor to cardiovascular morbidity and mortality, with poor adherence to treatment remaining a key issue. This study aimed to evaluate medication use, adherence levels, and factors influencing compliance among patients with hypertension, as well as the role of pharmaceutical care in improving outcomes. A cross-sectional survey was conducted among 200 hypertensive outpatients using a structured questionnaire that assessed sociodemographic, clinical, and pharmacotherapeutic data. Adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS-8). Hypertension was more prevalent among married, employed individuals with higher education. Modifiable risk factors included smoking (40%), alcohol use (36.7%), low physical activity (66.7%), and high salt intake (53.3%). Common comorbidities included hypercholesterolemia, diabetes, and cardiovascular or cerebrovascular diseases. All patients received combination therapy, with diuretics being the most prescribed (96.7%). Only 10% showed high adherence, while over half had low adherence. Key barriers were treatment cost, reliance on phytotherapy, and irregular medication use. Participation in the national “Affordable Medicines” program was reported by 80% of respondents. Adherence to antihypertensive therapy remains low and is affected by both clinical and socioeconomic factors. Enhancing pharmaceutical care and ensuring access to affordable medications are vital to improving treatment compliance and achieving better blood pressure control.