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Article
Compliance of Hypertensive Patients to Medication in AL-Imam AL-Hussein medical City- Kerbala- 2018

Authors: Zahraa Ismael Abdul Majeed Alnasrawi --- Shahrazad S. Al Jobori --- Hassan Ali A. Nassrallah
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2018 Volume: 11 Issue: 2 Pages: 4048-4058
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: High blood pressure (BP) is estimated to cause 7.5 million deaths worldwide, around 12.8% of the whole deaths . It is a major risk factor for coronary artery disease and its complications, heart failure, renal insufficiency, stroke and blindness in diabetic patients.Aim: This study is designed to determine the compliance of hypertensive patients attending the consultation clinics of internal medicine in Al-Imam Al-Hussein medical city with treatment regimen and the causes of noncompliance.Method: A descriptive cross- sectional study conducted in the outpatient clinics of Al- Imam Al-Hussein medical city in Kerbala during the period from March till June 2018.Total study sample was 335 hypertensive patients ,their ages over 25 years were selected by convenience sampling procedure according to the inclusion criteria . They were interviewed and assessed using special questionnaire format based on sociodemographic data, Morisky 8- item medication adherence scale (MMAS-8) ,and measuring of blood pressure.Results: the mean age of the patients was 58.69 ± 11.87 years. Good compliance with treatment was present in only 28.36% of the sample, 25.67% with partial compliance and 45.97% had poor compliance. Good control of blood pressure was present only in 23.3% of the patients .The absence of symptoms was the first isolated cause of non-compliance to medication 21.9%, followed by forgetfulness 18.8%, the cost of medication 16.3%, then negligence and carelessness of patients 9.4%, while 23.1% of the patients had more than one specific reason to their poor compliance.Conclusions: the study revealed a low rate of medication compliance and low level of blood pressure control with strong association between them. Compliance increased with age, male gender, higher level of education and income, longer duration of the disease, presence of complications, using healthy diet and having positive believe about hypertension treatment and its consequences.


Article
Compliance of Diabetic patients

Author: Riyadh K Lafta
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2009 Volume: 8 Issue: 1 Pages: 17-22
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background Diabetes is likely to be the fifth leading cause of death. Global excess mortality attributable to diabetes is estimated at 2.9 million deaths which is equivalent to 5.2% of world all-cause mortality. Compliance with medical advice is essential for controlling the disease; it is affected by many factors related to the patient, the disease, the physician and the family. Objective To assess the level of diabetic patients’ compliance with diet, drugs and visits, and to assess its effect on the disease control through certain indicators. Methods A total of 300 diabetic patients from different age categories, both males and females, were included in this study. The patients are usually either self-referral or referred from other hospitals, primary health care centers, governmental general practice clinics or private clinics. A questionnaire form was constructed to collect data about the demographic characteristics of the patients, about diet and medications. Files of the patients were reviewed to have an idea about their compliance. Results Compliance with diet was medium in half of the patients, while with drugs; it was good in 60.3%, and 38.7% had good compliance to visits. The best compliance with diet (38.2%) was seen in the age group 40-49 year while the least (19.2%) was in the age group (30-39)[ (χ²=2.65, P>0.05), 37.4% of the patients who are using oral hypoglycaemic agents, and 36.7% of those using insulin had good compliance with diet (χ²=7.10, P<0.05). Conclusion We can conclude from this study that the diabetic patients (represented by the study sample) have poor compliance with diet and visits, the duration of the disease was the most common variable found to predict compliance.

Keywords

Diabetic --- compliance --- Iraq


Article
Compliance Issue in Type II Diabetes: Does it Reduce the Prevalence of Cardiovascular Risk Factors?

Author: Yousif Abdul Raheem
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 2 Pages: 125-134
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACK GROUND:Type 2 diabetes, which is the most common form of diabetes, has an alarming increasing rate. It is a recognized risk factor for cardiovascular disease (CVD). Non-compliance with healthy life styles, anti-diabetic drugs and diet are the central issues in patient's management as it might synergist other CVD risk factors.OBJECTIVE:The aims of this study were to find out the compliance, prevalence of CVD risk factors, and any association between them in type 2 diabetic patients.METHODS:A cross-sectional design and a convenient sample of 820 diabetic patients were used in conducting this study for the period from the 1st October, 2006 to 31st December, 2008. A Structured questionnaire was used to collect demographic information from the patients. 10 questions were used to determine the patient's compliance. The classic risk factors; obesity, hyperglycemia (HG), hypertension (HT), and hypercholesterolemia (HC), have been studied for each patient and compared with his/her compliance to find any association.RESULTS:The results of this study revealed that there were only 187 out of 820 (22.80%) with good compliance and 297 (36.22%), 336 (40.98%) patients with fair and poor compliance respectively. The prevalence of obesity, over weight, uncontrolled HG, HT (systolic, diastolic or both) and presence of HC in our diabetic patients were 27.32%, 36.83%, 51.95%, 40.73 and 30.37 respectively. Good compliance was associated significantly with normal body weight, controlled HG, absence of HT, and absence of HC.CONCLUSION:The study concluded that less than one third of our diabetic patients had good compliance. CVD risk factors are prevalent among them, and this prevalence is associated significantly with the level of compliance. Understanding the reasons behind these forms of non-compliance is an important key to the successful development of potential program to decrease the CVD risk factors and associated complications


Article
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Authors: Layla Hassan Mohmed --- Haitham Issa Al – Banna
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 2 Pages: 145-150
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT: BACKGROUND: Medical non-compliance has been identified as a major public health problem in the treatment of Hypertension. OBJECTIVE: To identify factors related to non-Compliance with the treatment of patients with Hypertension.PATIENTS AND METHODS: A total number of (400) hypertensive patient was enrolled to assess compliance rate at Shorsh General Hospital from July 21/2006 to July 21/2007, using a structured questionnaire. RESULT: The study revealed a low compliance rate among hypertensive patients, Males were less compliant (65.6%) than females (46%). Smokers (61.7%) more than non-smokers (50.6%),non-regular follow-up (76.7%) more than regular, primary and secondary education (68.5%) more than illiterate and high education, more than one medication (66.9%)than single medication. Poverty was the main cause of non-compliance (38.1) while absence of drugs and medical staff are the least to cause non-compliance (2.7%). CONCLUSION: Compliance rate in general is low in our study. Compliance rate is more in female, no family history, single drug medication, non-smokers, no other chronic diseases, more than 10 years of hypertension. Patient’s knowledge about their disease is insufficient because there are no health educational programs


Article
Compliance of Diabetic patients

Authors: Riyadh K Lafta --- Ula Faiq --- Abdul-Hameed Al-Kaseer
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2008 Volume: 7 Issue: 2 Pages: 17-22
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Diabetes is likely to be the fifth leading cause of death. Global excess mortality attributable to diabetes is estimated at 2.9 million deaths which is equivalent to 5.2% of world all-cause mortality. Compliance with medical advice is essential for controlling the disease; it is affected by many factors related to the patient, the disease, the physician and the family.Objective: To assess the level of diabetic patients’ compliance with diet, drugs and visits, and to assess its effect on the disease control through certain indicators.Methods: A total of 300 diabetic patients from different age categories, both males and females, were included in this study. The patients are usually either self-referral or referred from other hospitals, primary health care centers, governmental general practice clinics or private clinics. A questionnaire form was constructed to collect data about the demographic characteristics of the patients, about diet and medications. Files of the patients were reviewed to have an idea about their compliance.Results: Compliance with diet was medium in half of the patients, while with drugs; it was good in 60.3%, and 38.7% had good compliance to visits. The best compliance with diet (38.2%) was seen in the age group 40-49 year while the least (19.2%) was in the age group (30-39)[ (χ²=2.65, P>0.05), 37.4% of the patients who are using oral hypoglycaemic agents, and 36.7% of those using insulin had good compliance with diet (χ²=7.10, P<0.05). Conclusion: We can conclude from this study that the diabetic patients (represented by the study sample) have poor compliance with diet and visits, the duration of the disease was the most common variable found to predict compliance.

Keywords

Diabetic --- compliance --- Iraq


Article
Compliance to Medical Therapy among Hypertensive Patients Attending the Out Patient Department of AL-Yarmouk Teaching Hospital
الالتزام بالعلاج الطبي لدى المرضى المصابين بأرتفاع ضغط الدم المراجعين للعيادة الاستشارية في مستشفى اليرموك التعليمي

Authors: Mohammed J. Kadhim د. محمد جواد كاظم --- Najla`a F. Jamil د. نجلاء فوزي جميل --- Zina M. Ramzi د. زينة رمزي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2007 Volume: 20 Issue: 2 Pages: 296-300
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract:Objective: To determine the compliance of hypertensive patients to their medical therapy.Method: Across- sectional study was carried out among 280 hyper tensive patients attending the out –patient department of AL-Yarmouk Teaching hospital between 1st of NOV2002-end of FEB2003. The data was collected by direct interview with each patient according to special questionnaire form.Results: The study showed that 187(66.8%) of the patients were complaint with their medical treatment regularly, while 93(33.2%) were non- complaint .poor concept of the disease and in correct information about the usage of drugs were the main reasons of non-compliance .Females and illiterate patients were significantly more compliant to medication than males and highly educated patients .Both monotherapy and single dose therapy had significantly influenced compliance to therapy .It was found that patients who were regular on follow- up were significantly more compliant than those who were irregular.Conclusion: One- third of patients didn’t take their medication regularly .Therefore, we recommended that hypertensive patients should have a better opportunity to know more about their disease , its risk factors and complications as well as the importance of compliance to their treatment. Key words: Compliance, Medical Therapy, Hypertension.

الملخص:الهدف: التعرف على مدى التزام المرضى المصابين بارتفاع ضغط الدم بالعلاج الطبي0طريقة اجراء البحث: اجريت دراسة مقطعية على (280) مريضا مصابا بارتفاع ضغط الدم والذين راجعوا العيادة الاستشارية في مستشفى اليرموك التعليمي للفترة من الاول من تشرين الثاني 2002 والى نهاية شباط 2003, تم جمع المعلومات باسلوب المقابلة المباشرة مع المرضى وبحسب استبيان0النتائج: لقد اظهرت الدراسة ان 187(66.8%) من المرضى كانوا ملتزمين بأخذ العلاج بشكل منتظم بينما 93(33.2%) كانون غير ملتزمين0 المفاهيم الخاطئة عن المرض او عدم معرفتهم بطرق استخدام الدواء كانت الاسباب الرئيسية لعدم الالتزام0 اظهرت الدراسة ان المرضى من الاناث وكذلك الاميين هم اكثر التزاما" من المرضى الذكور والمرضى الحاصلين على الشهادات الجامعية ولقد اظهرت ارتباط ذا مغزى احصائي0 كان لاستخدام نوع واحد من الادوية او استخدام الدواء مرة واحدة في اليوم علاقة معنوية احصائية في مدى التزام المرضى بعلاجاتهم0 ولقد لوحظ ان المرضى الذين هم تحت المتابعة الطبية المنتظمة اكثر التزاما من الذين هم تحت المتابعة غي المنتظمة0الاستنتاج: ان ثلث المرضى كانوا غير الملتزمين باخذ الدواء بشكل منتظم وذلك بسبب المفاهيم الخاطئة عن المرض او عدم معرفتهم بطرق استخدام الدواء0لذلك ننصح بأن يكون للمرضى المصابين بأرتفاع ضغط الدم فرصة افضل لكي يتعرفوا اكثر على طبيعة مرضهم, عوامل خطورته ومضاعفاته وكذلك اهمية الالتزام بالعلاج الطبي


Article
Compliance to Antituberculous Drugs among Patients in Erbil, Kurdistan Region of Iraq

Author: Shapol Jalal Kokha Ubed, Hamanejm H. Jaff
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2019 Volume: 16 Issue: 2 Pages: 99-103
Publisher: Babylon University جامعة بابل

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Abstract

Introduction: In Erbil, Kurdistan region of Iraq, some patients registered with tuberculosis (TB) diagnosis in Chest and Respiratory DiseasesCenter have interrupted treatment before completing their course, and many patients take their treatment irregularly due to different reasons. Inthis study, we try to determine the percentage of patients who are noncompliant to antituberculous drugs, to know the causes of noncomplianceand to compare the outcome of patients taking drugs irregularly to those who take them regularly. Materials and Methods: Patients enrolled inthis study were those who were diagnosed as having TB and registered in Erbil Chest and Respiratory Center during the years 2015 and 2016.Data were collected from patient forms and registers. For most patients, the causes of interruption in the course of treatment are not documentedin the registers, and thus patients had been called by phone to know factors behind that. Results: Among 394 patients registered in this study,it was found that 57 patients (15%) registered to having TB have been registered as default from the treatment and 14 patients (3.55%) haveinterrupted their treatment because they had been wrongly diagnosed as TB. Fifteen patients (3.8%) have completed their treatment, but theirfollow‑up was not documented. One (0.25%) of the patients completed his treatment outside Iraq. Another patient was originally from othergovernorates (Al‑Anbar) and completed his treatment when he returned to his governorate. Two (0.5%) were non‑Iraqi patients who returnedto their countries and their outcome is unknown. Five (1.27%) of the patients stopped treatment due to side effects of drugs; three (0.8) of themwere told by the referring doctor to stop treatment. Conclusion: Most TB‑infected patients who were registered in Erbil Chest and RespiratoryDiseases Center were compliant to the treatment but with occasional interruptions. Not all patients who were registered as default were reallydefaulters as many of those have completed their treatment, but their follow‑up was not documented, and many were misdiagnosed as TB


Article
Non-compliance to treatment among type 2diabetic men in Mosul: A case-control study

Author: Waleed G.A. Al-Taee وليد غانم الطائي
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2009 Volume: 35 Issue: 2 Pages: 147-153
Publisher: Mosul University جامعة الموصل

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ABSTRACT
Context: Non-compliance to treatment among diabetic patients is a world-wide problem and its underlying risk factors can be the subject of many studies in different localities.
Objective: To identify risk factors for non-compliance to treatment plan among type 2 diabetic men attending Al-Wafaa Center for diabetes in Mosul City.
Methods: A case-control study design has been adopted. A special questionnaire form has been prepared and filled in by the investigator for each patient (case and control) through direct interview with patients.
Results: Study results revealed a significant association between non-compliance and socio-economic strata, duration of disease >10 years, number of tablets >2 daily, frequency of taking medication >2, poor patient satisfaction about health personnel, body mass index >30 and sedentary life style activities.
On the other hand, an inverse association was found between non-compliance and urban place of residence, marriage, 10 and 20 school level of education, taking medical treatment without herbals and type A personality.
Conclusion: The study concluded that health care professionals are in need to identify risky patients for non-compliance and recommends to use the counseling approach of communication before applying any individual patient management plan characteristics.
Keywords: Type 2 diabetes, compliance, treatment.

خلفية إجراء الدراسة: يعتبر عدم التزام مرضى السكري بالعلاج من المعضلات العالمية وإن دراسة عوامل الخطورة لعدم الإلتزام من الأمور التي يمكن أن تحد من مضاعفات المرض وتأثيراته السلبية على صحة مرضى السكري .هدف الدراسة: التعرف على عوامل الخطورة لعدم الإلتزام بخطة العلاج لدى المرضى المصابين بداء السكر- النوع الثاني والمراجعين لمركز الوفاء لداء السكري في مدينة الموصل .طريقة إجراء الدراسة: تم اختيار تصميم دراسة العينة والشاهد حيث أعد الباحث نموذج خاص لجمع البيانات تم ملأه من قبل الباحث لكل مريض (عينة كان أم شاهد) وبأسلوب المقابلة المباشرة مع المريض.نتائج الدراسة: أظهرت نتائج الدراسة وجود علاقة إحصائية معنوية بين عدم الالتزام بالعلاج وتدني المستوى الإقتصادي للفرد، ومدة الإصابة بالمرض لأكثر من عشر سنوات، وأخذ أقراص علاج أكثر من إثنين ولأكثر من مرتين باليوم، ووجود عدم قناعة لدى المريض بالكوادر الصحية، ومعيار البدانة أكثر من 30 وشحة إجراء النشاطات البدنية في نمط المعيشة. ومن ناحية أخرى فقد لوحظ وجود علاقة إحصائية عكسية بين عدم الالتزام بالعلاج والسكن في المدينة، والزواج، ومستوى التعليم الابتدائي والثانوي، وأخذ العلاج الطبي بدون أعشاب ونمط الشخصية .استنتاجات الدراسة: هناك حاجة ملحة لمقدمي الرعاية الصحية في التحديد المسبق للمرضى المعرضين لحالة عدم الالتزام بالعلاج وتوصي باللجوء إلى استخدام أسلوب المشاورة الطبية معهم قبل البت بخصائص خطة العلاج لأي منهم .


Article
Assessment of Patients’ Compliance with Essential Hypertension

Author: Samer R. Alwey
Journal: nursing national Iraqi specility المجلة العراقية الوطنية للعلوم التمريضية ISSN: 18122388 Year: 2008 Volume: 21 Issue: 2 Pages: 1-10
Publisher: Baghdad University جامعة بغداد

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Abstract

AbstractObjective:This study aims to asses the patients' compliance with essential hypertension in respect to antihypertensive medications, follow-up, dietary pattern and health habits, to identify the associated long-term complications, and to find out the relationship between patient's compliance, and demographic characteristics such as age, gender, level of education, and duration of disease.Methodology: A descriptive study was carried out in Nasiriyah Teaching Hospital to achieve presented objectives . Results: The results of the study revealed that there were a significant association between educational level and total patient's compliance, a significant association was found between the duration of disease and complications, the majority (63%) of the sample was non-complaint, most of them was males with low level of education and (70%) of them had complications. A greater number (21%) suffering from (Cerebrovascular accident). Recommendation: The research recommends that establishing well-equipped specialized hypertension clinics, educational program should be designed, antihypertensive drugs should be supported by government, antihypertensive medications must be obtained from the out patient clinic to avoid buying them from private pharmacies to maintain patients compliance, and further study can be conducted in Iraq to determine the impact of non-compliance of patients with essential hypertension.

الخلاصــة الهـدف: لتقييم مطاوعة مرضى فرط ضغط الدم الأساسي المتعلقة بالأدوية الخافضة لفرط ضغط الدم، المتابعة، النظام الغذائي والعادات الصحية، لمعرفة المضاعفات المرفقة للمدى البعيد ولإيجاد العلاقة بين مطاوعة المرضى والصفات الديموغرافية ( العمر، الجنس، المستوى الثقافي، مدة الإصابة بالمرض والاختلاطات). المنهجيـة: أجريت الدراسة الوصفية في العيادة الاستشارية لمستشفى الناصرية التعليمي لتحقيق أهداف الدراسة.النتائـج: أظهرت نتائج الدراسة وجود علاقة بين المستوى التعليمي ومطاوعة المرضى الكلية ووجود علاقة بين مدة الإصابة بالمرض مع المضاعفات وان أكثر مرضى الدراسة 63 % هم غير مطاوعين وغالبيتهم من الرجال وذات مستوى تعليمي متدني و 70% منهم يعانون من مضاعفات وأكبر عدد منهم 21% مصابين بالجلطة الدماغية.التوصيـات: أوصى الباحث بإنشاء عيادات متخصصة ومتكاملة لمرضى فرط ضغط الدم الأساسي، إعداد برنامج تثقيفي، دعم حكومي للأدوية الخافضة لفرط ضغط الدم، توفر الأدوية في العيادات الاستشارية ومنع بيعها في الصيدليات الأهلية لتأمين مطاوعة المرضى وإجراء دراسة أخرى في العراق لمعرفة الصعوبات التي تؤدي إلى عدم مطاوعة مرضى فرط ضغط الدم الأساسي.


Article
COMPLIANCE OF HYPERTENSIVE PATIENTS TO THERAPY

Author: Muna F. Abbas
Journal: AL-TAQANI مجلة التقني ISSN: 1818653X Year: 2005 Volume: 18 Issue: 1 Pages: 105-113
Publisher: Foundation of technical education هيئة التعليم التقني

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Abstract

A cross-sectional study of hypertensive patients was conducted in Sumer Public Medical Clinic , and drug complince was estimated according to regularity of using drugs and blood pressure control . Two hundred sixty hypertensive patients were included in this study . the data were collected by using a specially designed questionnaire . the were tested using the Chi-square test . The results revealed that the mean age of the study sample was (57.7+ 10.6 years) , (55.7%) had the disase for more than 5 years . And it was found that only (39.6%) had controlled blood pressure . And (53.1%) of the patients had been treated with one drug , (62.7%) were taking a single dose/ day and (32.7%) took their drugs irregularly , of whom (55.4%) because of emergence of side effect . It was concluded that although about two thirds of the patients were compliant with their thrapy , only little mor than one third had controlled blood pressure which indicates bad management of those patients , and the number of drugs is the most important factor that highly affect the regularity of drugs taken by the patients and consequently on control of blood pressure .

تم اجراء دراسة مقطعية على المرضى المصابين بارتفاع ضغط الدم والمسجلين في العيادة الشعبية في حي سومر وحدة الامراض المزمنة وتم احتساب امتثال المرضى للعلاج نسبة الى التزامهم بأخذ العلاج بصورة منتظمة والسيطرة عاى ارتفاع ضغط الدم. شملت الدراسة 260 مريض مصاب بارتفاع ضغط الدم فقط من المراجعين للعيــادة خلال الفترة من الاول / ايار/2002 لغاية الثلاثين/ايلول/2002. أخذت المعلومات والبيانات الخاصة بالدراسة باستخدام طريقة المقابلة, وتم تحليل البيانات واختبارها احصائيا.أظهرت النتائج بأن متوسط عمر العينة كان (57.7+10.6) سنة وان 55.7 % من العينة هم مصابون بالمرض لأكثر من 5 سنوات. ووجد ان 39.6% من مجموع العينة كانوا ذو ضغط منظبط و 53.1%يستخدمون نوع واحد من العلاج و 62.7% يتناولون جرعة واحدة من الدواء في حين 32.7%يتناولون علاجهم بصورة غير منتظمة و اتضح ان السبب الرئيسي لعدم الانتظام في تناول العلاج هو ظهور اعراض جانبية ومضاعفات. الاستنتاجات: من خلال عرض النتائج تبين انه على الرغم من ان ثلثين من المرضى كانوا ممتثلين لعلاجهم الا انه حوالي ثلث منهم كان ضغطهم منضبط, مما يشير الى سوء المتابعة لهؤلاء المرضى. وان عدد الادوية التي يتعاطاها المريض لها تأثير عالي على انتظام المريض في اخذ العلاج وبالتالي على انضباط الضغط

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