Determinants of Medication Non-Adherence Among the Elderly with Co-Existing Hypertension and Type 2 Diabetes Mellitus in Rural Areas of Udupi District in Karnataka, India

Figures & data

Table 1 Cal-Clusters Sampled (Probability of Selection for Each Sampled Cluster)

A	B	C	D	E	F	G	H
Cluster	Size (a)	Cumulative Sum	Clusters Sampled	Prob 1	Individuals Per Cluster (c)	Prob 2	Overall Weight
PHC 1	104	104	59	59%	72	69%	2.4
PHC 2	146	250	234	84%	72	49%	2.4
PHC 3	52	302
PHC 4	197	499	409	113%	72	36%	2.4
PHC 5	199	698	584	114%	72	36%	2.4
PHC 6	142	840	759	81%	72	51%	2.4
PHC 7	34	874(b)

Table 2 Frequency and Percentage of Sample Socio-Demographic Characteristics (n=360)

Variables	Frequency (f)	Percentage (%)
Age in years:
60–69	195	54.2
70–79	118	32.8
80–89	46	12.7
90–99	01	0.27
Gender:
Male	137	38.1
Female	223	61.9
Educational status:
Illiterate	71	19.7
Primary school	161	44.7
Secondary school/Higher secondary school	107	29.7
Diploma/Graduate	20	5.6
Post graduate	1	0.3
Present occupation:
Employed	27	7.5
Not employed	299	83.1
Self employed	34	9.4
Living status:
Living alone	20	5.6
With spouse	62	17.2
With family	278	77.2
Family income status
Below poverty line (BPL)	230	63.9
Above poverty line (APL)	130	36.1
Receiving pension
Yes	185	51.4
Pension amount:
Lower than 1000	322	89.4
1001–10,000	20	5.6
More than 10,001	18	5.0
Enrolled in an insurance scheme
Yes	137	38.1

Table 3 Correlation Between Influencing Factors and Medication Compliance n=360

Variables	Medication Compliance
	r	p
Undesirable person-related factors (Individual factors)	−0.444	0.000*
Good familial support including financial support (Familial factors)	0.185	0.000*
Poor accessibility and availability of healthcare facilities (healthcare system or social factors)	−0.209	0.000*
Detrimental medication-related factors including the high cost of medication (medication-related factors)	−0.237	0.000*

Note: *p<0.05 level of significance.

Table 4 Association Between Selected Socio-Demographic Variables and Medication Compliance of Elderly with Co-Morbid Conditions of HTN and Diabetes Mellitus n=360

Socio-Demographic Variable	Adherent		Non-Adherent		χ^2(df)	p-value
	f	%	f	%
Age (in years)
60–69	85	23.6	110	30.6	0.449(2)	0.799
70–79	52	14.4	66	18.3
80–89	22	6.1	24	6.7
90–99	01	0.27	0	0
Gender
Male	62	17.2	75	20.8	0.059(1)	0.808
Female	98	27.2	125	34.7
Educational status
Illiterate	29	8.1	42	11.7	9.440(4)	0.051
Primary school	62	17.2	99	27.5
Secondary and Higher secondary school	55	15.3	52	14.4
Diploma and Graduate	13	3.6	07	1.9
Postgraduate	1	0.3	0	0
Present occupation
Employed	12	3.3	15	4.2	1.284(2)	0.526
Not employed	136	37.8	163	45.3
Self-employed	12	3.3	22	6.1
Living status
Living alone	8	2.2	12	3.3	0.759(2)	0.684
With spouse	25	6.9	37	10.3
With family	127	35.3	151	41.9
Family income status
Below poverty line (BPL cardholders)	96	26.7	134	37.2	1.888(1)	0.169
Above poverty line (APL cardholders)	64	17.8	66	18.3
Getting pension
Yes	83	23.1	102	28.3	0.027(1)	0.869
No	77	21.4	98	27.2
Amount of pension received
<1000	138	38.3	184	51.1	3.256(2)	0.196
1001–10,000	11	3.1	9	2.5
>10,001	11	3.1	7	1.9
Enrolled in insurance (Govt/Private)
Yes	60	16.7	77	21.4	0.038(1)	0.846
No	100	27.8	123	34.1

Note: P<0.05 level of significance.

Table 5 Association Between Selected Clinical Variables and Medication Compliance of Elderly with Co-Morbid Conditions of HTN and Diabetes Mellitus n=360

Clinical Variables	Adherent		Non- Adherent		χ^2(df)	p-value
	f	%	f	%
Functional status
No impairment
Yes	138	38.3	183	50.8	2.536(1)	0.111
No	22	6.1	17	4.7
Vision impairment
Yes	124	34.4	172	47.8	4.394(1)	0.036*
No	36	10	28	7.8
Hearing impairment
Yes	44	12.2	71	19.7	2.617(1)	0.106
No	116	32.2	129	35.8
Memory impairment
Yes	48	13.3	106	29.4	19.210(1)	0.000*
No	112	31.1	94	26.1
Physical disability
Yes	24	6.7	50	13.9	5.443(1)	0.020*
No	136	37.8	150	41.6
Number of functional impairments
Live with single impairment (<1)	95	26.4	66	18.3	25.013(1)	0.000*
Live with more than one or multiple impairments (>1)	65	18.1	134	37.2
Duration of hypertensive illness (In years)
− 3	30	8.3	41	11.4	1.041(5)	0.959
3.1–6	27	7.5	36	10
6.1–9	22	6.1	28	7.8
9.1–12	29	8.1	38	10.6
12.1–15	21	5.8	20	5.5
>15	31	8.6	37	10.3
Duration of diabetic illness (In years)
0–3	28	7.8	43	11.9	5.635(5)	0.343
3.1–6	34	9.4	49	13.6
6.1–9	19	5.3	31	8.6
9.1–12	30	8.3	34	9.4
12.1–15	21	5.8	15	4.2
>15	28	7.8	28	7.8
Presence of other co-morbid illnesses (Stroke, CHD, arthritis, asthma, COPD, cancer, BPH, knee pain/leg pain/back pain, etc.)
Yes	96	26.7	152	42.2	10.618(1)	0.001*
No	64	17.8	48	13.3

Note: *p<0.05 level of significance.

Table 6 Association Between Treatment Facility and Medication Related Variables and Medication Compliance of Elderly with Co-Morbid Conditions of HTN and Diabetes Mellitus n=360

Health Facility/Medication-Related Variable	Adherent		Non-Adherent		χ^2(df)	p-value
	f	%	f	%
Treatment facility
Government	27	7.5	32	8.9	0.050(1)	0.824
Private	133	36.9	168	46.7
Number of prescribed medications
1–2	33	9.2	40	11.1	0.175(2)	0.916
2–4	72	20	87	24.1
>4	55	15.3	73	20.3
Self-consumption of Ayurveda/complementary/herbal therapies
Yes	29	8.0	50	13.9	2.453(1)	0.117
No	131	36.4	150	41.7

Notes: p<0.05 level of significance.

Table 7 Association Between Knowledge Related Variables and Medication Compliance of Elderly with Co-Morbid Conditions of HTN and Diabetes Mellitus n=360

Demographic Variable	Adherent		Non- Adherent		χ^2(df)	p-value
	f	%	f	%
Knowledge about health conditions and their associated complications
Completely aware	65	18.0	30	8.3	37.406(3)	0.000*
Partially aware	54	15	69	19.2
Somewhat aware	23	6.4	68	18.9
Unaware	18	05	33	9.2
Knowledge about the importance of taking regular medications
Completely aware	68	18.8	46	12.8	18.797(3)	0.000*
Partially aware	51	14.2	67	18.6
Somewhat aware	23	6.4	51	14.2
Unaware	18	05	36	10
Awareness about how to take medications
Completely aware	126	35	135	37.5	5.887(3)	0.117
Partially aware	19	5.3	33	9.2
Somewhat aware	7	1.9	14	3.9
Unaware	8	2.2	18	05

Note: *p<0.05 level of significance.