Abstract
Objective To assess adherence to anti-hypertensive medication by
pregnant women and to understand the factors associated with adherence
or lack thereof. Design Observational study. Setting Antenatal clinics.
Population 100 pregnant women with either chronic hypertension or
gestational hypertension who were being treated using at least one
anti-hypertensive medication. Methods Participants were prospectively
recruited through two Australian maternity hospitals over a 10-month
period. A 23-item questionnaire, which incorporated a validated
adherence scale, was administered to all participants. Data from clinic
records were extracted as needed. Main Outcome Measures Self-reported
adherence, BP control and reasons for nonadherence. Results Participants
(mean age 33 [±4.9] years; mean gestation 29 (±7) weeks) had a
median blood pressure (BP) of 130/80mmHg (IQR: 16/15). Sixty-five women
had chronic hypertension, of whom 13 were diagnosed during the
pregnancy, before 20 weeks gestation. Thirty-five women had gestational
hypertension. Ninety-two per cent of participants had sub-optimal
adherence. There were no significant differences in adherence scores
between participants with chronic hypertension and their counterparts.
The main reasons for sub-optimal adherence were: intentionally putting
up with medical problems before taking any action, confusion about the
medication, and making changes to the recommended medication regimen to
suit lifestyle. Conclusions Nine out of 10 pregnant women using
anti-hypertensives self-reported some degree of suboptimal adherence,
intentionally and/or unintentionally. Health professionals, including
pharmacists, general practitioners and obstetricians, have a role in
promoting optimal adherence. Funding No funding received. Keywords
Adherence, anti-hypertensives, pregnancy, gestational hypertension,
chronic hypertension.