{"title":"Medication Adherence and Health-Related Quality of Life Among Hypertensive Patients in Nepal: A Cross-Sectional Study.","authors":"Supuspa Lama, Prasanna Dahal, Sunil Neupane, Bipindra Pandey, Dharanidhar Baral, Kadir Alam, Sagun Kharel","doi":"10.1002/puh2.70289","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Good adherence to antihypertensive medication is critical for optimal blood pressure control and reducing disease-related complications. This study aimed to assess patients' medication adherence and health-related quality of life (HRQoL) and explore the relationship between medication adherence and HRQoL among hypertensive patients.</p><p><strong>Methods: </strong>A cross-sectional study was carried out at the Scheer Memorial Adventist Hospital (SMAH) in Bagmati Province, Nepal, from March 2023 to June 2023. The General Medication Adherence Scale (GMAS) and the European Quality of Life-5 Dimensions-5 Levels (EQ-5D-5L) questionnaires were used to assess medication adherence and HRQoL, respectively. Logistic regression analysis was employed to explore the relationship between participants' characteristics, medication adherence levels, and HRQoL impairment across the five dimensions of EQ-5D-5L. Statistical significance was set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>A total of 300 patients were surveyed, of whom only 52.33% were adherent to their antihypertensive medication. Similarly, the mean (±SD) GMAS score of the participants was 25.21 (±6.5), and the mean (SD) EQ index and EQ-VAS scores were 0.84 ± 0.22 and 72.22 ± 11.67, respectively. The percentages of issues in various dimensions were 47.3% for mobility, 19.66% for self-care, 26.66% for usual activities, 70.33% for pain/discomfort, and 58% for anxiety/depression. Multiple logistic regression analysis revealed that higher education attainment, longer disease duration, and enrollment to health insurance schemes were significantly associated with improve patients' medication adherence (<i>p</i> < 0.05). Participants who were adherent to prescribed medication had lower odds of reporting problems with mobility (OR 0.21, 95% CI 0.11-0.39; <i>p</i> < 0.001), usual activities (OR 0.52, 95% CI 0.27-1.00; <i>p</i> = 0.05), pain (OR 0.17, 95% CI 0.08-0.32; <i>p</i> < 0.001), and anxiety (OR 0.36, 95% CI 021-0.62; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Medication adherence was suboptimal in substantial proportion of hypertensive patients. Adherence to medication was linked to an improved HRQoL in patients with hypertension regardless of sociodemographic and clinical variables.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 2","pages":"e70289"},"PeriodicalIF":1.8000,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240105/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Public health challenges","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/puh2.70289","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Background: Good adherence to antihypertensive medication is critical for optimal blood pressure control and reducing disease-related complications. This study aimed to assess patients' medication adherence and health-related quality of life (HRQoL) and explore the relationship between medication adherence and HRQoL among hypertensive patients.
Methods: A cross-sectional study was carried out at the Scheer Memorial Adventist Hospital (SMAH) in Bagmati Province, Nepal, from March 2023 to June 2023. The General Medication Adherence Scale (GMAS) and the European Quality of Life-5 Dimensions-5 Levels (EQ-5D-5L) questionnaires were used to assess medication adherence and HRQoL, respectively. Logistic regression analysis was employed to explore the relationship between participants' characteristics, medication adherence levels, and HRQoL impairment across the five dimensions of EQ-5D-5L. Statistical significance was set at p < 0.05.
Results: A total of 300 patients were surveyed, of whom only 52.33% were adherent to their antihypertensive medication. Similarly, the mean (±SD) GMAS score of the participants was 25.21 (±6.5), and the mean (SD) EQ index and EQ-VAS scores were 0.84 ± 0.22 and 72.22 ± 11.67, respectively. The percentages of issues in various dimensions were 47.3% for mobility, 19.66% for self-care, 26.66% for usual activities, 70.33% for pain/discomfort, and 58% for anxiety/depression. Multiple logistic regression analysis revealed that higher education attainment, longer disease duration, and enrollment to health insurance schemes were significantly associated with improve patients' medication adherence (p < 0.05). Participants who were adherent to prescribed medication had lower odds of reporting problems with mobility (OR 0.21, 95% CI 0.11-0.39; p < 0.001), usual activities (OR 0.52, 95% CI 0.27-1.00; p = 0.05), pain (OR 0.17, 95% CI 0.08-0.32; p < 0.001), and anxiety (OR 0.36, 95% CI 021-0.62; p < 0.001).
Conclusions: Medication adherence was suboptimal in substantial proportion of hypertensive patients. Adherence to medication was linked to an improved HRQoL in patients with hypertension regardless of sociodemographic and clinical variables.
背景：良好的抗高血压药物依从性对于最佳血压控制和减少疾病相关并发症至关重要。本研究旨在评估高血压患者药物依从性与健康相关生活质量（HRQoL）的关系，探讨高血压患者药物依从性与HRQoL的关系。方法：于2023年3月至2023年6月在尼泊尔Bagmati省的Scheer纪念基督复临医院（SMAH）进行横断面研究。采用通用药物依从性量表（GMAS）和欧洲生活质量5维度5水平问卷（EQ-5D-5L）评估患者的药物依从性和HRQoL。采用Logistic回归分析在EQ-5D-5L五个维度上探讨被试特征、药物依从性水平与HRQoL损害之间的关系。结果：共调查300例患者，其中仅52.33%的患者坚持降压药物治疗。受试者的GMAS平均（±SD）评分为25.21（±6.5）分，EQ指数和EQ- vas平均（SD）评分分别为0.84±0.22和72.22±11.67。各维度的问题比例分别为：行动能力47.3%、自我照顾19.66%、日常活动26.66%、疼痛/不适70.33%、焦虑/抑郁58%。多元logistic回归分析显示，较高的受教育程度、较长的病程和参加健康保险计划与改善患者的药物依从性（p p = 0.05）、疼痛（OR 0.17, 95% CI 0.08-0.32）显著相关。结论：相当一部分高血压患者的药物依从性不理想。无论社会人口学和临床变量如何，坚持服药与高血压患者HRQoL的改善有关。
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