IMPACTS OF COUNSELING ON ADHERENCE TO PRESCRIBED MEDICATIONS AND BLOOD PRESSURE OF HYPERTENSIVE PATIENTS IN FOUR INDONESIAN PRIMARY HEALTH CENTERS

摘要

Objective: To analyze the impacts of pharmacist counseling on adherence to medications and reduction in systolic and diastolic blood pressures (SBP/DBP) of hypertensive outpatients. Methods: A retro-prospective cohort study was undertaken to evaluate the impacts of two-month period counseling on medication adherence and SBP/DBP of hypertensive patients (n=47) insured by Social Security Organizing Body in primary health centers (Medan Deli, Helvetia, Darussalam, and Teladan) in Medan. Inclusion criteria were patients diagnosed with hypertension, age ≥ 18 years, and under treatment of antihypertensive drugs. A questionnaire was used to assess characteristics of the patients, antihypertensive drugs provided, and BP. The eight-item Morisky Medication Adherence Scale (MMAS-8) of each patient was assessed. Characteristics of the patients and antihypertensive drugs provided were descriptively analyzed. Impacts of counseling on medication adherence and SBP/DBP of the patients were analyzed using Wilcoxon test. All analyses were performed using Statistical Package for the Social Sciences (SPSS, version 19, Chicago, IL, USA) (p value <0.05 was considered significant). Results: Characteristics of the patients: male, 23.4%, female, 76.6%, mean age, 61.22 ± 9.90 (years). MMAS-8 score improved significantly from 4.58 before counseling to 6.28 after counseling, p = 0.000. There was a reduction in SBP from 160.49±23.15 mmHg before counseling to 149.04 ± 21.02 mmHg after counseling, p = 0.001. DBP also reduced from 91.23 ± 12.82 mmHg before counseling to 87.14 ± 9.94 mmHg after counseling, p = 0.014. Conclusion: Counseling improves adherence to prescribed medications and BP in hypertensive patients. Keywords: Hypertension, Medication adherence, Morisky scale.