Doctor-Patient Communication to Improve Adherence to Anti- Hypertensive Treatment

Abstract

Background: Non-adherence to medication increases patient’s risk of morbidity, mortality and economic wastage of scare medical resources. This study was conducted to assess the role of doctor-patient communication and duration of consultation, as tools to improve adherence to hypertension treatment. Methods: Data of this cross-sectional study were collected by face to face interview and document review at Combined Military Hospital (CMH), Dhaka among 253 conveniently recruited hypertensive patients attending outpatient department during July 2016 to June 2017. Mean-age of the respondents was 49.2 (±10.4) years, mostly married male (54.9% male, 95.3% married). Mean consultation duration experienced by the respondents was 5.3 (± 1.3) minutes. Among the participants, 63.64% experienced effective communication, 66% were adherent and 34% were non-adherent to medication. Among the respondents with effective communication, 92.5% were adherent to medication. On the contrary, among the respondents with ineffective communication, 80.4% were non-adherent. Results: Duration of consultation had significant association with adherence to hypertension treatment (p<0.001). Association between communication and adherence to medication was highly significant (p<0.001). Binary logistic regression revealed that respondents were 3.23 times more adherent to medication with favorable response to the item- ‘Doctor gave me as much information as I wanted’ (p = 0.041); and 10.24 times with favorable response to the item- ‘Doctor checked to be sure that I understood everything’(p=0.006). Patients’ faithfulness in carrying out prescription and proscriptions correctly, depends on the adequacy and accuracy of patient’s knowledge of what they were supposed to do and on their motivation. Conclusion: Thus, it is necessary to formulate interventions to scale up communication skill of the physicians, and devise effective ways to educate patients on medication of chronic diseases. Further studies on characteristics of consultation to make it motivating and more effective may be conducted. Bangladesh Med Res Counc Bull 2018; 44: 145-151