Open AccessFactors affecting non‐adherence to medical appointments among patients with hypertension at public health facilities in Punjab, India
Author(s) -
Das Bidisha,
Neupane Dinesh,
Singh Gill Sandeep,
Bir Singh Gurinder
Publication year - 2021
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.14142
Subject(s) - medicine , feeling , health facility , medical prescription , family medicine , public health , asymptomatic , medical record , health care , medical emergency , nursing , population , environmental health , health services , surgery , psychology , social psychology , economic growth , economics
Abstract Daily adherence to antihypertensive medications is necessary to control hypertension. Under the State hypertension control program, hypertensive patients are enrolled in public health settings, provided with 30‐day medication prescriptions, and advised to return to the health facility monthly. However, at least 50‐60% of patients do not visit the health facility for their scheduled follow‐up appointments. The authors aimed to document the major reasons for missed appointments and to characterize patient and health system barriers. By telephone, the authors interviewed 300 randomly selected patients who missed appointments for more than three consecutive months. Out of the 300, 206 were interviewed using a pre‐structured questionnaire to explore patients’ experiences along with medical record reviews from the patient database. Not feeling sick or not experiencing any symptoms (24.8%) was the major reason why patients did not return to the clinic, followed by far distance from the facility (22.3%). Among other reasons for missing follow‐up appointments, lack of instructions/guidance from the facility (15.3%), acute illness among patients (8.3%), and long waiting time at the facilities (7%) were also documented. Most of these patients (55.4%) continued treatment from other sources, and a majority (54%) preferred private clinics. These results suggest the need for a more patient‐centered care model, including education about hypertension as an asymptomatic but life‐threatening condition and addressing the barrier of travel distance between a patient's home and the health facility. Further, introducing a reminder system using telephone calls, text messages, or home visits by health workers may increase the follow‐up rate among patients.