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Evaluation of Medication Adherence and Associated Factors in Hypertensive

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DOI: 10.5530/ijpi.2021.4.76

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Int. J. Pharm. Investigation, 2021; 11(4) : 426-431 Original Article

Evaluation of Medication Adherence and Associated Factors in

Hypertensive Patients in Bangalore, India; A Cross-Sectional Study
Amar Prashad Chaudhary1,*, Jeswin George2, Kaveri Kadowade1, Lubna Faiyza1, Rabiya Anjum1, Uma V M1, Sharath K N1
Department of Pharmacy Practice, Mallige College of Pharmacy, Bangalore, Karnataka, INDIA.
1

Department of Clinical Pharmacy, Mallige Hospital, Bangalore, Karnataka, INDIA.

2

ABSTRACT
Background: This survey aims to determine medication compliance 2.4 (P-value < .05), whereas the total score of patients with comorbidities
among hypertension patients and discover factors influencing medication more than 5 have a sharp rise of 3.4 (P-value < .05). Therefore, reducing
compliance. Methods: This study incorporated a cross-sectional study medication adherence. Conclusion: According to this survey, only 77% of
design. The Hill-Bone Compliance to High Blood Pressure Therapy Scale patients are adherent to their antihypertensive medicines. Additionally, this
was used in this study to evaluate medication adherence in hypertensive study reveals that individuals with more than five children positively affect
individuals. Additionally, this scale aids in monitoring sodium intake control medication adherence. However, patients with long-term hypertension and
and appointment-keeping habits. Results: 69 (77%) of 90 hypertension many comorbidities have a detrimental effect.
patients comply with their antihypertensive therapy, whereas 21 (23%) Key words: Antihypertensive medication, Hill-Bone, Hypertension, Medical
are non-compliant. The average score of patients on the Hill-Bone Compliance
history, Medication Compliance.
to High Blood Pressure Therapy Scale is 20.21 ± 4.21. Subsequently, the
medication-taking score is 11.97 ± 3.44, the sodium reduction score is 4.37 Correspondence
± 1.4, and the appointment-keeping score is 3.88 ± 1.34. Simultaneously, Dr. Amar Prashad Chaudhary,
studying the impact of patients’ socio-demographic characteristics and Department of Pharmacy Practice, Mallige College of Pharmacy, Rajiv Gandhi
medical history on medication adherence. There was a considerable drop University of Health Sciences, Bangalore-560090, Karnataka, INDIA.
in the overall score of patients having more than five children by 5.59
(P-value < .05), thus improving medication adherence. In contrast, the Email id: [email protected]
total score of patients with hypertension from 6 to 10 years shot up by DOI: 10.5530/ijpi.2021.4.76

INTRODUCTION
Almost one-fourth of the world’s population is affected by hypertension literature available to establish the influence of various factors on
and is estimated to affect 1.56 billion individuals by 2025.1,2 Hypertension medication adherence. Therefore, the study aims to evaluate the
is prevalent in 30.7% of the people in India and is significantly more medication adherence and factors affecting medication adherence
frequent in those over the age of 65.3 Hypertension is asymptomatic among hypertensive patients.
for a lengthy period; hence, its detrimental effects may manifest years
later. Uncontrolled hypertension surges the probability of developing MATERIALS AND METHODS
cardiovascular disorders such as ischemic heart disease and can result in The research was carried out at Mallige Hospital in Bangalore, Karnataka’s
consequences such as stroke. capital city. The cross-sectional study was conducted in December
Despite the abundance of effective therapy, still, more than 50% of 2020 for five months. This study strictly adhered to Strengthening
patients treated with hypertension quit within a year of diagnosis. Only the Reporting of Observational Studies in Epidemiology (STROBE)
about half of those take at least 80% of their prescription medicines.4 standards for reporting.7
As a result of inadequate adherence to antihypertensive therapy, about
two-thirds of individuals diagnosed with hypertension do not attain Target population, setting, and sampling
optimal blood pressure control.4 The situation in India isn’t different, The target group consisted of adults (over the age of 18) who had been
with about a quarter of the patient having poor medication adherence.5,6 diagnosed with hypertension at least one year before data collection
Various factors have been associated with poor blood pressure control— and were using at least one antihypertensive medication. This study
one of the most crucial factors is non-adherence to medication. did not exclude patients who had several comorbidities. This aided in
According to WHO, medication adherence is defined as “the extent to determining the effect of additional comorbidities on the participant’s
which a person’s behaviour in taking medication, lifestyle management, medication compliance level. In addition, this study excluded individuals
diet, corresponding with agreed recommendations from a health who had been diagnosed with hypertension but were younger than
care provider.”4 Some of the vital causes for poor compliance to the 18 years old, had been diagnosed with hypertension for less than one year
hypertensive medication in the Indian scenario was found to be the weak or were not taking any antihypertensive medication. The patient’s blood
knowledge of hypertensive medicines among the patients, polypharmacy, pressure was checked using a sphygmomanometer and categorized into
multiple comorbidities, socioeconomic status, and educational status.5 control and uncontrolled blood pressure
Multiple studies have been conducted to study medication adherence This study recruited a convenience sample of 98 people, of which 8 were
among hypertensive patients in India. However, there is limited removed due to missing data, failing to meet the criteria, or providing

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International Journal of Pharmaceutical Investigation, Vol 11, Issue 4, Oct-Dec, 2021 426
 Chaudhary, et al.: Medication Adherence in Hypertensive Patients

misleading information. Data were collected from inpatient departments male, and 39 (43.3%) were female. Among the 90 patients, the majority
apart from the critical care unit (ICU) and surgery unit for two months. (46%) of them belonged to age group of 66 to 85 years, while 32 (35.6%)
In those two months, an estimated 150 hypertension patients were were between the ages of 51 and 65, 8 (8.9%) were in the age range of
hospitalized. The sample size for this study was determined using the 35 to 50, and 6 (6.7%) were in the age group of > 85. While 38 patients
convenience sampling method; the sample size is 90 for this study.8 (42.2%) have a university education, 27 patients (30%) have a high school
education, and 10 patients (11.1%) have only an elementary school
Instrument education. Simultaneously, 15 patients (16.7%) lacked literacy. Of the 90
The data collection instrument was made up of three pieces. The first patients, 37 (41.1%) were normal weight, 31 (34.4%) were overweight,
section included a questionnaire on the participants’ socio-demographics. 16 (17.8%) were obese, and 6 (6.7%) were underweight. Most (95.4%)
The second section had the participants’ medical history. The third of the patients were married; however, 5 (5.6 %) were widows. Only
section included a scale to assess patient medication compliance. The 10 were smokers (11.1 %) out of 90 patients. The majority of patients
Hill-Bone Compliance to High Blood Pressure Therapy Scale (Hill-Bone (54.4%) have between one and two children, whereas 36 patients (40 %)
CHBPTS), developed by Kim et al., is used in the third section to assess have between 3 and 5 children, and 5 patients (5.6 %) have more than 5
patient compliance with antihypertensive medication therapy.9 This scale children.
satisfies the study’s objectives and has been cross-culturally validated.9-11 The medical history of the patient is summarised in Table 2. Among 90
The Hill-Bone CHBPTS questionnaire consists of 14 items divided into patients, almost one-third of patients had uncontrolled blood pressure.
three unique subscales. Subscales include a scale for reducing sodium Of 90 patients, 36 (40%) had hypertension for one to five years, 22 (24.4%)
intake, keeping appointments and medication use.9 The questionnaire had hypertension for six to ten years, and 32 (35.6%) had hypertension
responses were coded on a four-point Likert scale. None of the time for more than ten years. The patients were on 1.5 ± .78 of antihypertensive
equals 1, part of the time equals 2, most of the time equals 3, and all of medicine and took 1.63 ± .97 daily antihypertensive pills. This study
the time equals 4. The overall score goes from 14 to 56. The higher the discovered that patients took an average of 4.6 ± 3.7 medications, and
patient’s drug adherence, the lower the total score. more than one-third were on polypharmacy. In addition, 15 patients

Operational definition
Medication Compliance Table 1: Socio-demographics of the patient.
Patients who comply at a rate of 80% or more are called compliant, Socio-demographic Details Frequency (%) (n = 90)
whereas those who comply at less than 80% are labelled non-compliant.6,12 Gender
The formula calculates the percentage of compliance
Male 51 (56.7%)
56 − Total score Female 39 (43.3%)
% compliant = * 100%
42 Age (in years)
35 - 50 8 (8.9%)
Polypharmacy
51 - 65 32 (35.6%)
The regular use of five or more drugs is termed Polypharmacy.13
66 - 85 44 (48.9%)
Blood Pressure > 85 6 (6.7%)
Uncontrolled blood pressure is defined as blood pressure equal to or
Body Mass Index (BMI)
greater than 140/90 mm Hg, while controlled blood pressure is defined
as less than 140/90 mm Hg.14 Underweight 6 (6.7%)
Normal 37 (41.1%)
Statistical analysis Overweight 31 (34.4%)
All the responses from the patient were recorded in Microsoft excel and Obese 16 (17.8%)
were checked for the accuracy of the data. Statistical Package for Social
Education
Science (SPSS) version 25 software were used for the statistical analysis.
The data analysis procedure included descriptive statistics to describe Illiterate 15 (16.7%)
the sample. For example, the mean and standard deviation was used to Primary School 10 (11.1%)
describe continuous variables whereas, frequency and percentage were High School 27 (30%)
used to describe categorical variables. In addition, linear regression
University 38 (42.2%)
was used to understand the impact of medical history and socio-
demographics of the patient on the Hill-Bone CHBPTS. Marital Status
Married 85 (95.4%)
Ethical Consideration Widow 5 (5.6%)
The Mallige College of Pharmacy’s research review board accepted our
No. of children
study (Approval no. MCP/RRB/004/19-20). The Helsinki Declaration of
1964 and its recent amendments were strictly followed in this study.15 The 1-2 49 (54.4%)
patients were explained the purpose of this study prior to the interview, 3-5 36 (40%)
and their verbal consent was taken. >5 5 (5.6%)
Smoking Status
RESULTS
Yes 10 (11.1%)
Table 1 summarises the socio-demographic features of the patients who
No 80 (88.9%)
contributed to this investigation. Of the 90 patients, 51 (56.7%) were

International Journal of Pharmaceutical Investigation, Vol 11, Issue 4, Oct-Dec, 2021 427
 Chaudhary, et al.: Medication Adherence in Hypertensive Patients

Table 2: Medical history of the patients.

Medical History Distribution
Blood Pressure (n = 90)
Controlled 62 (68.9%)
Uncontrolled 28 (31.1%)
Duration of Hypertension (in years) (n = 90)
1-5 36 (40%)
6 - 10 22 (24.4%)
>10 32 (35.6%)
Total number of antihypertensive drugs prescribed 1.5 ± .78
(mean ± SD)
Total number of drugs prescribed (mean ± SD) 4.6 ± 3.7
Total number of antihypertensive pills per day 1.63 ± .97 Figure 1: Compliance of patients with antihypertensive medications.
(mean ± SD)
No. of Patient on Polypharmacy (n = 90) 38 (42.2%)
(P-value < .05), while their medication-taking subscale score decreases
Total number of other comorbidities by 4.94 (P-value < .05). Furthermore, the patient has a number of
0 15 (16.7%) children between 3 to 5; their sodium intake subscale score was reduced
1 26 (28.9%) by .789 (P-value < .05).
The effect of a patient’s medical history on the Hill-Bone CHBPTS and its
2 24 (26.7%)
subscale scores is summarised in Table 5. Among the variables discovered,
3 10 (11.1%) the duration of hypertension and the number of comorbidities other
≥4 15 (16.7%) than hypertension have a substantial adverse effect on the Hill-Bone
CHBPTS and its subscale. According to this study, patient’s total score
increases by 2.4 (P-value < .05), and medication-taking scale score
Table 3: Domains of the Hill-Bone CHPTS. increases by 2.1 (P-value < .05) when they have hypertension for 6 to
10 years. Furthermore, when patients have four or more comorbidities,
Mean (total score/
Mean of the total

their total score and medication-taking subscale score increase by 3.4

No. of items

no. of item
Maximum

Deviation
Minimum

Standard

and 2.8 points, respectively (P-value < .05). As a result, the patient’s
score

medication compliance and medication-taking behaviour deteriorate.

DISCUSSION
Reducing sodium intake 3 3 9 4.37 1.4 1.45 The primary goal of this study is to ascertain patient compliance with
antihypertensive treatment. Additionally, this study reveals the variables
Appointment keeping 2 2 8 3.88 1.34 1.94
that influence drug adherence in hypertension patients. According to
Medication taking 9 9 28 11.97 3.44 1.33 this study, 77% of those individuals adhere to their antihypertensive
Total Score 14 14 37 20.21 4.21 1.44 medications, whereas 23% aren’t compliant. Furthermore, this study
discovered that as the number of children increases, medication
compliance improves significantly. In contrast, a patient with four
(16.7%) had no comorbidity other than hypertension, 26 patients or more comorbidities other than hypertension and who has had
(28.9%) had one, 24 patients (26.7%) had two, 10 patients (11.1%) had hypertension for six to ten years reduces medication compliance.
three, and 15 patients (16.7%) had four or more comorbidities. The average Hill-Bone CHBPTS score for the patients in this research was
Table 3 summarises the Domains of the Hill-Bone CHPTS. The findings 20.21 ± 4.21, which is comparable with the findings of a national survey
of this study indicated that overall adherence to hypertension treatment performed by Chia et al. in Malaysia.2 When comparing the subscales,
regimens was moderate to good, with a score of 1.44, where 1 shows the Malaysians had better medication adherence than the participants in our
highest potential rate of compliance and 4 marks the lowest. Adherence study but somewhat worse appointment keeping and salt intake control.2
It is probably because Malaysians have higher literacy, per capita income
to sodium restriction and medication use was moderate to good, with
and the government’s public health expenditure is 3.8% of its GDP.
a score of 1.45 and 1.33, respectively. Appointment punctuality was
On the other hand, India has low literacy, per capita income, and the
moderate among patients, with a score of 1.94. The patient’s compliance
government’s public health expenditure is estimated to be 1.28% of its
with the antihypertensive treatment is illustrated in Figure 1. According GDP. Similarly, the study conducted in Poland by Uchmanowicz et al.
to this study, 69 (77%) patients comply with their antihypertensive was consistent with the findings of this study.16
medication therapy, whereas 21 patients (23%) are non-compliant.
Furthermore, a survey done in a tertiary care hospital in India by
Table 4 summarises the effect of socio-demographic variables on the Hill- E. Mutneja et al. discovered that 80.8 % of patients adhere to their
Bone CHBPTS scale and its subscale. Among the identified risk factors, antihypertensive therapy, similar to this study’s findings.6 Compared to
the Hill-Bone CHBPTS scale and its subscale are significantly affected Palestinians residing in the Gaza Strip, the patients in this research have
by the number of children. It is discovered that when the number of a higher rate of medication adherence and salt control but a lower rate of
children increases, medication compliance improves significantly. When appointment keeping.17 The plausible reason is due to higher poverty and
a patient has more than five children, their total score decreases by 5.59 inadequate healthcare facilities among the Palestinian people.

428 International Journal of Pharmaceutical Investigation, Vol 11, Issue 4, Oct-Dec, 2021
 Chaudhary, et al.: Medication Adherence in Hypertensive Patients

Table 4: Impact of socio-demographic factors on the Hill-Bone CHBPTS and its subscale score.
Socio-demographic Hill-Bone CHBPTS Hill-Bone CHBPTS Sub-Scale
characteristics Total Score Medication-Taking Appointment keeping Reducing Sodium intake

P-value B P-value B P-value B P-value B

(95% CI) (95% CI) (95% CI) (95% CI)

Constant 0.000 21.41 0.000 11.245 0.000 4.518 0.000 5.647

(16.4 − 26.3) (7.2 – 15.2) (2.8 – 6.1) (4 – 7.2)
Gendera 0.549 −.7 0.528 −.592 0.918 −.04 0.857 −.068
(−3 − 1.6) (−2.4 – 1.2) (−.8 − .7) (−0.8 − 0.6)
Age (in years)b
36-50 0.786 −.49 0.510 −.973 0.955 .035 0.460 .44
(−4.1 – 3.1) (−3.9 – 1.9) (−1.1 – 1.2) (−0.7 – 1.6)
51-66 0.489 −.723 0.484 .588 0.703 −.134 0.428 .268
(−1.3 – 2.7) (−1 – 2.2) (−0.8 − 0.5) (−0.4 − 0.9)

> 85 0.504 1.6 0.359 1.772 0.965 .035 0.795 −.201

(−3.1 – 6.3) (−2 – 5.5) (−1.5 – 1.6) (−1.7 – 1.3)
(Body Mass Index)
BMIc
Underweight 0.592 −1.22 0.628 −.891 0.723 −.272 0.930 −.065
(−5.7 – 3.3) (−4.5 – 2.7) (−1.7 – 1.2) (−1.5 – 1.4)
Overweight 0.44 .896 0.490 .643 0.799 .099 0.680 .154
(−1.4 – 3.1) (−1.2 – 2.4) (−0.6 − 0.8) (−.5 − 0.9)
Obese 0.858 −.26 0.904 −.142 0.726 −.172 0.912 .052
(−3.1 – 2.6) (−2.4 – 2.1) (−1.1 − 0.8) (−.8 − 0.9)

Educationd
Illiterate 0.443 1.24 0.235 1.553 0.953 −.032 0.599 −.276
(−1.9 − 4.4) (−1. – 4.1) (−1.1 – 1) (−1.3 − 0.7)
Primary School 0.563 .951 0.127 2.025 0.607 −.283 0.139 −.791
(−2.3 – 4.2) (−.5 – 4.6) (−1.3 − 0.8) (−1.8 − 0.2)
High School 0.616 −.642 0.649 −.468 0.694 −.169 0.990 −.005
(−3.1 − 1.8) (−2.5 – 1.5) (−1 − .6) (−.8 − .8)

Marital Statuse 0.872 −.373 0.557 1.096 0.670 −.331 0.132 −1.138
(−4.9 – 4.2) (−2.6 – 4.7) (−1.8 – 1.2) (−2.6 − .3)
No. of Childrenf

3-5 0.085 −1.84 0.386 −.743 0.376 −.317 0.024* −.789

(−3.9 − 0.2) (−2.4 − .9) (−1 − 0.3) (−1.4 − −0.1)
>5 0.028* −5.59 0.016* −4.943 0.418 −.682 0.973 .027
(−10.5 − −0.6) (−8.9 − −.9) (−2.3 − 0.9) (−1.5 – 1.6)
Smoking Statusg 0.915 −.17 0.388 −1.144 0.945 .038 0.084 .930
(−3.4 − 3) (−3.7 – 1.4) (−1 – 1.1) (−.1 – 1.9)
R square 0.122 .155 .037 .180

Multiple linear regression is statistically significant at the P-value < 0.05 level

Reference category
a
Gender: Female
b
Age (in years): 66 – 85
c
BMI: Normal
d
Education: University
e
Marital status: widow
f
Number of children: 1 – 2
g
Smoking status: non smokers

International Journal of Pharmaceutical Investigation, Vol 11, Issue 4, Oct-Dec, 2021 429
 Chaudhary, et al.: Medication Adherence in Hypertensive Patients

Table 5: Impact of the medical history of patients on Hill-Bone CHBPTS and its subscale.
Medical History Hill-Bone CHBPTS Hill-Bone CHBPTS Sub-Scale
Total Score Medication Taking Appointment keeping Reducing Sodium intake
P-value B P-value B P-value B P-value B
(95% CI) (95% CI) (95% CI) (95% CI)
Constant 0.000 17.9 0.000 10.3 0.000 3.6 0.000 3.9
(15.2 – 20.5) (8.1 – 12.4) (2.8 – 4.5) (3 – 4.8)
Blood Pressurea 0.608 −0.52 0.917 .087 0.523 −.2 0.266 −.39
(−2.5 −1.4) (−1.5 −1.7) (−0.8 − 0.4) (−1 − 0.3)
Duration of hypertensionb .
6 – 10 years 0.036* 2.4 0.029* 2.1 0.706 −0.14 0.202 0.51
(0.1 – 4.7) (0.2 – 3.9) (−0.9 − 0.6) (−0.2 – 1.3)
>10 years 0.410 0.88 0.286 .94 .576 0.202 0.496 −.253
(−1.2 – 3) (−0.8 – 2.6) (−0.5 − 0.9) (−0.9 − 0.4)

Total number of drugs 0.279 0.22 0.330 .16 .091 .11 0.413 −.059
prescribed (−.1 − .6) (−0.1 − 0.5) (−0.01 − 0.2) (−0.2 − 0.08)
Total number of 0.653 −0.3 0.563 −.32 .974 .007 0.974 0.008
antihypertensive drugs (−1.6 − 1) (−1.4 − 0.7) (−0.4 − 0.4) (−0.4 − 0.4)
prescribed
Total number of 0.558 −0.35 0.605 .25 0.630 −.097 0.348 .19
antihypertensive pills intake (−.8 – 1.5) (−.7 − 1.2) (−.4 − 0.3) (−.2 − 0.6)
per day
Polypharmacyc 0.256 −1.8 0.189 −1.7 0.325 −.52 0.438 .42
(−4.9 − 1.3) (−4.2 − 0.8) (−1.5− 0.5) (−.6 – 1.5)
No. of other comorbiditiesd .
No comorbidity 0.121 2.1 0.179 1.5 .720 .165 0.328 .46
(−.5 – 4.8) (−.7 – 3.7) (−0.7 – 1.0) (−0.4 – 1.4)
2 comorbidities 0.440 .92 0.488 .67 .991 −.004 0.543 .25
(−1.4 – 3.2) (−1.2 – 2.6) (−0.7 − 0.7) (−0.5 – 1)
3 comorbidities 0.904 −.19 0.581 −.72 .397 −.457 0.077 .98
(−3.3 −2.9) (−3.3 – 1.8) (−1.5 −0.6) (−0.1 – 2)
≥ 4 comorbidities 0.031* 3.4 0.031* 2.8 .512 .344 0.604 .28
(0.3 – 6.) (0.2 – 5.3) (−0.6 – 1.3) (−0.7 – 1.3)
R square 0.156 0.160 0.076 0.104

Multiple linear regression is statistically significant at the P-value < 0.05 level
Reference category
a
Blood Pressure: Controlled blood pressure
b
Duration of hypertension: 1- 5 years
c
Polypharmacy: No polypharmacy
d
No. of other comorbidity: 1 comorbidity

According to a systematic study conducted by Shahin et al., social A study conducted among Korean patients discovered that sex, marital
support such as disease awareness and reminders from family members status, smoking, and education did not affect medication adherence,
and friends have a beneficial effect on medication adherence among which was consistent with the findings of our study.22 In contrast, age
hypertension patients.18 This study demonstrates a considerable has a substantial effect on medication adherence among Korean patients,
improvement in medication adherence among hypertensive patients which contradicts the results of this study.22 In addition, age and
with more children, owing to children’s additional social and emotional education both affect medication adherence in Chinese hypertension
support.19 On the contrary, family members have little effect or no patients, which contradicts the findings of this study.20 Both studies,
effect on Chinese patients’ drug adherence.20 Other socio-demographic however, conclude that gender and marital status did not affect
variables reported in this study do not appear to substantially affect medication adherence.20 The review of these studies reveals that most
patient medication adherence. Similarly, Biffi et al. found no evidence of studies impact age on medication adherence; maybe due to the small
a significant influence of sex on medication adherence in hypertensive sample size, this study couldn’t find its impact.
patients; nevertheless, research conducted among Indian hypertensive This study shows a considerable decline in the adherence to
patients discovered considerable impacts.6,21 antihypertensive drugs with an increase in comorbidities. In addition,

430 International Journal of Pharmaceutical Investigation, Vol 11, Issue 4, Oct-Dec, 2021
 Chaudhary, et al.: Medication Adherence in Hypertensive Patients

the survey conducted in Ethiopia and Egypt also found a significant 6. Mutneja E, Yadav R, Dey AB, Gupta P. Frequency and predictors of compli-
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ACKNOWLEDGEMENT Aging. 2017;1(3):igx025. doi: 10.1093/geroni/igx025, PMID 29795792.
20. Zhang Y, Li X, Mao L, Zhang M, Li K, Zheng Y, et al. Factors affecting medication
We are thankful to Dr Shailesh Yadav, Umme Ayman, and Jamuna TR adherence in community-managed patients with hypertension based on the
for their invaluable contribution to data collection and ethical clearance. principal component analysis: Evidence from Xinjiang, China. Patient Prefer
Adherence. 2018;12:803-12. doi: 10.2147/PPA.S158662, PMID 29785095.
CONFLICT OF INTEREST 21. Biffi A, Rea F, Iannaccone T, Filippelli A, Mancia G, Corrao G. Sex differences
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The authors declare no conflict of interest.
PMID 32641331.
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Article History: Submission Date : 30-08-2021; Revised Date : 12-09-2021; Acceptance Date : 24-10-2021.
Cite this article: Chaudhary AP, George J, Kadowade K, Faiyza L, Anjum R, Uma VM, Sharath KN. Evaluation of Medication Adherence and Associated Factors
in Hypertensive Patients in Bangalore, India: Cross-Sectional Study. Int. J. Pharm. Investigation. 2021;11(4):426-31.

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