Socioeconomic status and its association with medication adherence among newly diagnosed hypertensive patients in Eastern India
Alapan Bandyopadhyay, Deyasinee PaulAbstract
Background:
Hypertension is a leading modifiable risk factor for cardiovascular disease and premature mortality. Despite the availability of effective treatments, adherence to antihypertensive medications remains suboptimal. Socioeconomic status, particularly family income, is a recognized determinant of medication adherence, but evidence from Eastern India is limited. The aim of the study was to assess the proportion of newly diagnosed hypertensive Indian patients having poor medication adherence and to find out if any association exists between poor medication adherence and their socioeconomic status.
Material and Methods:
A cross-sectional study was conducted over 6 months among 300 adult patients diagnosed with hypertension within the past 12 months. Data on patient characteristics were obtained using a structured questionnaire, and socioeconomic status of the patients was calculated using the modified B.G. Prasad Scale of Socioeconomic Status Classification 2025. Medication adherence was assessed using the Medication Adherence Report Scale-5 (MARS-5), a validated self-reported tool for assessing adherence in chronic diseases. Multivariable logistic regression was used to identify predictors, including socioeconomic status, of low adherence.
Results:
Only 17.3% of participants demonstrated high adherence (MARS-5 score: ≥23), while 38.3% of participants showed low adherence (score: ≤19). A significant inverse relationship was observed between family income and adherence levels. Compared to the Class I income group, Class III, IV, and V had progressively higher odds of low adherence (adjusted odds ratio [AOR] = 13.9, 22.7, and 85.6, respectively;
Conclusion:
Medication adherence in newly diagnosed hypertensive patients in Eastern India is significantly influenced by socioeconomic status. Interventions targeting financial hardship and increasing access to care are essential to improve adherence and associated health outcomes.