Comparative analysis of non-adherence to medication treatment for systemic arterial hypertension in urban and rural populations

Magnabosco, Patricia; Teraoka, Eliana Cavalari; Oliveira, Edward Meirelles de; Felipe, Elisangela Aparecida; Freitas, Dayana; Marchi-Alves, Leila Maria

doi:10.1590/0104-1169.0144.2520

Acessibilidade / Reportar erro

Brasil

Revista Latino-Americana de Enfermagem

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Articles • Rev. Latino-Am. Enfermagem 23 (1) • Jan-Feb 2015 • https://doi.org/10.1590/0104-1169.0144.2520 copy

Comparative analysis of non-adherence to medication treatment for systemic arterial hypertension in urban and rural populations¹ 1 Paper extracted from doctoral dissertation "Systemic arterial hypertension in urban and rural population of Sacramento/MG: prevalence and non-adherence to medication treatment", presented to Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

to evaluate the indexes and the main factors associated with non-adherence to medication treatment for systemic arterial hypertension between urban and rural areas.

METHOD:

analytical study based on an epidemiological survey with a sample of 247 hypertensive residents of rural and urban areas, with application of a socio-demographic and economic questionnaire, and treatment adherence assessment. The Pearson's Chi-square test was used and the odds ratio (OD) was calculated to analyze the factors related to non-adherence.

RESULTS:

the prevalence of non-adherence was 61.9% and it was higher in urban areas (63.4%). Factors significantly associated with non-adherence were: male gender (OR=1.95; 95% CI 1.08-3.50), age 20-59 years old (OR=2.51; 95% CI 1.44-4.39), low economic status (OR=1.95; 95% CI 1.09-3.47), alcohol consumption (OR=5.92, 95% CI 1.73-20.21), short time of hypertension diagnosis (OR=3.07; 95% CI 1.35-6.96) and not attending the health service for routine consultations (OR=2.45; 1.35-4.42).

CONCLUSION:

the socio-demographic/economic characteristics, lifestyle habits and how to relate to health services were the factors that presented association with non-adherence regardless of the place of residence.

Descriptors
Hypertension; Medication Adherence; Urban Population; Rural Population

Study variable %		Rural (n=53) %	Urban (n=194) %	Total Population (n=247)
Gender
	Female	56.6	72.7	69.2
	Male	43.4	27.3	30.8
Age Group (years)
	≥ 60 years old	39.6	66.0	60.3
	Up to 59 years old	60.4	34.0	39.7
Skin color
	White	92.5	73.2	77.3
	Non-white	7.5	26.8	22.7
Education
	< 8 years of study	84.9	71.6	74.5
	≥ 8 years of study	15.1	28.4	25.5
Economic Status*
	A/B	13.2	29.4	25.9
	C/D/E	86.8	70.6	74.1
Smoking^†
	No	84.9	85.6	85.4
	Yes	15.1	14.4	14.6
Alcohol consumption^‡
	No	88.7	90.2	88.7
	Yes	11.3	9.8	11.3

Study variable %		Rural (n=53) %	Urban (n=194) %	Total (n=247)
Time of diagnosis (Systemic Arterial Hypertension)
	More than 3 years	77.4	77.8	83.0
	Up to 3 years	22.6	22.2	17.0
Pills/day
	1 to 2	48.1	53.8	52.3
	≥ 3	51.9	46.2	47.7
Service Type
	Health Insurance/Private	3.8	22.7	23.9
	Brazilian Unified Health System	96.2	77.3	76.1
Difficulty to access
	No	60.4	68.8	66.4
	Yes	39.6	32.0	33.6
Reason for seeking the health service
	Routine visit*	62.3	64.4	63.6
	To get medication	5.7	7.6	3.6
	Only emergency	32.1	28.8	32.8

Study variable		Non-adherence(%)			Likelihood Ratio	Confidence Interval (95%)	p*
Study variable		Rural (n=53)	Urban (n=194)	Total (n=247)	Likelihood Ratio	Confidence Interval (95%)	p*
Gender						(1.08-3.50)	0.025‡
	Female	50.0	58.9	57.3	1
	Male	65.2	75.5	72.4	1.95
Age Group (years)						(1.44- 4.39)	0.001‡
	≥ 60 years old	47.6	54.7	53.7	1
	Up to 59 years old	62.5	80.3	74.5	2.51
Skin color						(0.74-2.62)	0.301
	White	59.2	60.6	60.2	1
	Non-white	25.0	71.2	67.9	1.39
Education						(0.66-2.17)	0.553
	< 8 years of study	55.6	62.6	60.9	1
	≥ 8 years of study	62.5	65.5	65.1	1.19
Economic status ^†						(1.09-3.47)	0.023‡
	A/B	42.9	50.9	50.0	1
	C/D/E	58.7	68.6	66.1	1.95
Smoking^‡						(0.90-4.51)	0.081
	No	55.9	60.8	59.7	1
	Yes	62.5	78.6	75.0	2.02
Alcohol consumption^§						(1.73-20.21)	0.002‡
	No	53.2	60.6	58.4	1
	Yes	83.3	89.5	89.3	5.92

Study variable		Non-adherence(%)			Likelihood Ratio	Confidence Interval (95%)	p*
Study variable		Rural (n=53)	Urban (n=194)	Total (n=247)	Likelihood Ratio	Confidence Interval (95%)	p*
Time of diagnosis						(1,35- 6,96)	0,005
	More than 3 years	53.7	58.3	58.0	1
	Up to 3 years	66.7	81.4	81.0	3.07
Pills/day						(0.67-1.91)	0.632
	1 to 2	40.0	63.6	58.5	1
	More than 3	70.4	58.8	61.6	1.13
Service Type						(0.92-3.01)	0.089
	Health insurance/Particular	50.0	50.0	52.5	1
	Brazilian Unified Health System	56.9	67.3	64.9	1.67
Difficulty to access						(0.41-1.22)	0.222
	No	53.1	67.4	64.6	1
	Yes	61.9	54.8	56.6	0.71
Reason for seeking the health service						(0.44-0.84)(1.35-4.42)	0.003
	Routine visit^†	48.5	56.0	54.1	1
	To get medication	100.0	59.3	77.8	2.20
	Only emergency	64.7	78.1	75.3	2.45

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding Author: Patrícia Magnabosco Universidade Federal de Uberlândia. Faculdade de Medicina Av. Pará, 1720 Bairro: Umuarama CEP: 38400-902, Uberlândia, MG, Brasil E-mail:magnabosco@famed.ufu.br, patimagnabosco@usp.br