One in four Filipinos has hypertension or high blood pressure. Hypertension increases a person’s risk for heart disease, stroke, and kidney damage, which are among the leading causes of death in the country. For every increase of 20 mm Hg in systolic blood pressure and every increase of 10 mm Hg in diastolic blood pressure, a person’s risk of stroke and ischemic heart disease doubles.
Lifestyle changes including a low-sodium, low-fat diet and regular physical activity together with medications can lower blood pressure effectively. Optimal hypertension management significantly reduces the risk of serious complications.
Dangers of poor compliance
Hypertensive patients who do not take their hypertension medications as prescribed by their doctor are five times more likely to be hospitalized, re-hospitalized, and die prematurely compared to hypertensive patients who comply with their treatment regimen.
The latest Philippine Heart Association (PHA) survey PRESYON 3 done in 2013 showed that about half of hypertensive Filipinos do not comply with treatment. The nationwide survey also revealed that hypertension-related stroke was the most common cause of death among hospitalized Filipino patients, the majority of who had uncontrolled hypertension and poor treatment compliance.
Barriers to compliance
There are a number of reasons a patient may not take hypertension medications as prescribed, according to the American Heart Association. In most cases, a combination of factors leads to poor treatment compliance.
Complicated drug therapies may “scare” a patient about perceived side effects of medication/s or lead to general confusion about the regimen. Poor communication between doctors and patients is also a factor. A doctor may find it difficult to explain the benefits and adverse effects of complex drug therapies while a patient may have a hard time understanding these.
Socioeconomic factors, such as low health awareness, high medication costs and lack of money are common barriers to compliance in the country. Many patients stop taking their medication as soon as they feel better or their blood pressure becomes normal, mistakenly believing their hypertension has been “cured” and therefore they no longer need treatment. Some simply forget (nakakalimutan) to take their medication.
Ways to improve compliance
Form good habits. Make sure that you are informed about your condition(s) as well as why you are taking your medications. Be honest about your preferences, limitations and priorities. Talk with your doctor, and follow up any questions or concerns you may have.
Stick with one pharmacy. Medication is not a convenience item—do not hop from pharmacy to pharmacy. Instead, form a relationship with one pharmacy. Get to know the staff and let the staff get to know you and your family and/or caregivers.
Also, make sure that your doctor knows where you buy your medications. Your pharmacist and doctor must work together to ensure safe treatment for you and your condition
Take advantage of technology. Set reminders on your phone or alarm clock to remind you when your dose is due. Create e-mail or text alerts to signal it’s time to take your medicine.
Use a pillbox. The best and easiest way to organize your medications is to put them in a weekly pillbox that has a compartment for each day. A pillbox doesn’t just visually remind you to take your medication but also prevents double doses.
Make a list of instructions for all of your medications. Create a daily or weekly checklist and keep it someplace where you will see it.
Place sticky note reminders. Stick the notes where you will see them, such as the fridge door or bathroom mirror.
Combine with a daily task. Tie taking your medication with an activity you do every day, such as making coffee or brushing your teeth.
Keep medications visible. Out of sight, out of mind. Put your medications in an easy-to-spot place, but make sure they’re out of reach of children.
Enlist a loved one’s help. Having a non-judgmental, positive person who understands your situation support you through treatment is a big help in treatment compliance, This person can help you remember to take your medicine or be there to give you a high-five after attending your doctor’s appointment.
– Eric Michael Santos, Medical Observer