Survey of the Adherence to the Antihypertensive Therapy in Urban Bulgarian Population

Objective: Adherence to the therapy is the Achilles heel of the management of the arterial hypertension. The aim of our study was to address the problem from the patient's perspective. Design and method: We asked 497 urban Bulgarian patients (aged between 35 and 70 years) with arterial hypertension, about their attitude and adherence to the prescribed therapy. 80% of the survey was done online and 20% were computer-assisted personalized interviews among older subjects. Quality control was done by GPS tracking of the interviewer, control of the duration of the survey, logical control of the interviews and 10% phone calls for confirmation with the patients. Results: We found out that 61% of the patients take 2 or more tablets daily for the treatment of hypertension. The preferred intake time was in the morning in 69% of the answers, but the predominant therapeutic regime was twice daily among 56% of the patients. In 56% of patients the number of pills remained the same during their follow up visits and in 26% -the number increased. 83% of patients with hypertension declared positive attitude towards their therapy, but 55% of them, admitted that they miss some of the doses of the prescribed medications. Asked about the reason for that, most of them- 63% answered: “I forgot to take them”. 30% of the hypertensive patients repeatedly perform “pill holidays”- stopping their therapy usually in the summer. Only 25% of the studied population were fully aware about the risks of non compliance. Being asked about how to improve their adherence, 44% of the patients answered they would prefer 1 tablet per day. Conclusions: Conclusion: Many Bulgarian urban patients experience difficulties to adhere to their antihypertensive treatment. Reducing the number of pills by increasing the use of SPCs could be one of the answers to the problem.