Determinants of Hypertension Treatment Adherence during the COVID-19 Pandemic: Lesson Learned from Various Studies Sites in Indonesia

Raehan Satya Deanasa, Alifa Alya Zalfa, Nurul Mufliha Patahuddin, Lathifah Dzakiyyah Zulfa, Sofia Hana, Anak Agung Bagus Putra Indrakusuma, Aizar Vesa Prasetyo, Gita Julianti Malik, Hesti Azzahra Tosadapotto, Raza Syahlevi Suwandri, Muhammad Nur Mahmudi, Rizma Adila Syakurah

Abstract


Background: Hypertension is the most common comorbid disease which can cause further complications in COVID-19 patients. On the contrary, the pandemic has also caused lower health services and adherence to hypertension therapy. This study aimed to examine the impact of the COVID-19 pandemic on medication adherence in people with hypertension in Indonesia.

Methods: The research was conducted using an analytical quantitative method. Patients with hypertension from seven islands across Indonesia were recruited based on eligibility criteria during Bulan Bakti 2021, a social outreach by Ikatan Senat Mahasiswa Kedokteran Indonesia about basic health across Indonesia. The demographic and medication history of the respondents were recorded. The Indonesian version of the Morisky Medication Adherence Scale (MMAS-8) questionnaire was distributed, and the medication adherence level was assessed.

Results: A total of 1155 patients, mainly females (62.2%) participated in this study. More than half of the patients had low adherence (55.25%). Males (Adjusted Odd Ratio (AOR) 0.777 [CI 95% 0.529–1.019]), employed (AOR 0.857 [CI 95% 0.495–1.483]), higher income (AOR 0.522 [CI 95% 0.393–0.713]), and those who had information from healthcare worker (AOR 0.583 [CI 95% 0.361–0.878]) were found to have better medication adherence in multivariate logistic regression test.

Conclusion: Medication adherence level in patients with hypertension during the pandemic is markedly low. Integrated preventive and promotive measures, especially from healthcare workers, are needed to prevent further morbidity and mortality.

 


Keywords


Adherence, COVID-19, hypertension, Indonesia, social determinant of health

Full Text:

PDF

References


  1. Susilo A, Rumende CM, Pitoyo CW, Santoso WD, Yulianti M, Herikurniawan H, et al. Coronavirus disease 2019: tinjauan literatur terkini. Jurnal Penyakit Dalam Indonesia. 2020;7(1):45–67.
  2. Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020;55(5):2000547.
  3. Gunawan A, Prahasanti K, Utama MR. Pengaruh komorbid hipertensi terhadap severitas pasien yang terinfeksi Covid 19. Jurnal Implementa Husada. 2020;1(2):136–51.
  4. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223–37.
  5. Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan Republik Indonesia. Laporan nasional Riskesdas 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan; 2020.
  6. Nurhidayati I, Aniswari, AY, Sulistyowati AD, dan Sutaryono S. Penderita hipertensi dewasa lebih patuh daripada lansia dalam minum obat penurun tekanan darah. Jurnal Kesehatan Masyarakat Indonesia. 2018;13(2):1–5.
  7. Chaker L, Falla A, Vander LS, Muka T, Imo D, Jaspers L, et al. The global impact of non-communicable disease on macro-economic productivity: a systematic review. Eur J Epidemiol. 2015;30(5):357–95.
  8. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021;398(10304):957–80.
  9. Page MR. The JNC-8 hypertension guidelines: an in-depth guide. Am J Manag Care. 2014;20(1 Spec No):E8.
  10. Shimels T, Kassu RA, Bogale G, Bekele M, Getnet M, Getachew A, et al. Magnitude and associated factors of poor medication adherence among diabetic and hypertensive patients visiting public health facilities in Ethiopia during the COVID-19 pandemic. PLoS One. 2021;16(4): e0249222.
  11. Srikartika VM, Cahya AD, Hardiati RSW. Analisis faktor yang memengaruhi kepatuhan penggunaan obat pasien diabetes mellitus tipe 2. Jurnal Manajemen dan Pelayanan Farmasi. 2016;6(3):205–12.
  12. Singh M, Lal P. Non-communicable diseases: challenges and impact of COVID-19 pandemic. Indian Pract. 2020;73(11):30–6.
  13. World Health Organization NCD Department. Rapid assessment of service delivery for NCDs during the COVID-19 pandemic. Geneva: WHO; 2020.
  14. Riani DA. Validasi 8-item Morisky Medication Adherence Scale versi Indonesia pada pasien hipertensi dewasa di Puskesmas Kabupaten Sleman dan Kota Yogyakarta [Thesis]. Yogyakarta: Universitas Gadjah Mada; 2017.
  15. Khayyat SM, Hyat ARS, Alhazmi RSH, Mohamed MM, Abdul HM. Predictors of medication adherence and blood pressure control among Saudi hypertensive patients attending primary care clinics: a cross-sectional study. PloS One. 2017;12(1):e0171255.
  16. Bantas K, Gayatri D. Gender and hypertension (data analysis of the Indonesia basic health research 2007). Jurnal Epidemiologi Kesehatan Indonesia. 2019 ;3(1):7–18.
  17. Bidmon S, Terlutter R. Gender differences in searching for health information on the internet and the virtual patient-physician relationship in Germany: exploratory results on how men and women differ and why. J Med Internet Res. 2015;17(6):e156.
  18. Cho SJ, Kim J. Factors associated with nonadherence to antihypertensive medication. Nurs Health Sci. 2014;16(4):461–7
  19. Listiana D, Effendi S, Saputra Ye. Faktor-faktor yang berhubungan dengan kepatuhan penderita hipertensi dalam menjalani pengobatan di Puskesmas Karang Dapo Kabupaten Muratara. Journal of Nursing and Public Health. 2020;8(1):11–22.
  20. Tambuwun AA, Kandou GD, Nelwan JE. Hubungan karakteristik individu dengan kepatuhan berobat pada penderita hipertensi di Puskesmas Wori Kabupaten Minahasa Utara. Jurnal KESMAS. 2021;10(4):112–21.
  21. Pratiwi W, Harfiani E. Faktor-faktor yang berhubungan dengan kepatuhan dalam menjalani pengobatan pada penderita hipertensi di Klinik Pratama GKI Jabar Jakarta Pusat. Prosiding Seminar Nasional Riset Kedokteran (SENSORIK). 2020;1(1):27–40
  22. Sinuraya RK, Destiani DP, Puspitasari IM, Diantini A. Tingkat kepatuhan pengobatan pasien hipertensi di fasilitas Kesehatan tingkat pertama di kota Bandung. Jurnal Farmasi Klinik Indonesia. 2018;7(2):124–33.
  23. Lu CH, Tang ST, Lei YX, Zhang MQ, Lin WQ, Ding SH, et al. Community-based interventions in hypertensive patients: a comparison of three health education strategies. BMC Public Health. 2015;15:33.




DOI: https://doi.org/10.15850/amj.v10n1.2675

Article Metrics

Abstract view : 713 times
PDF - 553 times



 This Journal indexed by

                  

          

 

Creative Commons License
AMJ is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

 


View My Stats