Medication compliance among individuals with hypertension and type 2 diabetes mellitus in urban slums of amalapuram: Findings from a cross-sectional study.

Nageswara  Rao T; B . Naga  Ramesh; Dr S Suguna; Dr Suresh Babu  Sayana

doi:10.51168/sjhrafrica.v6i9.2065

Authors

Dr. Nageswara Rao. T Associate Professor, Department of Pharmacology, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India
B. Naga Ramesh Tutor, Department of Pharmacology, Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India
Dr. S Suguna Associate Professor, Department of Pharmacology, Government Medical College and General Hospital, Khammam, Telangana, India
Dr. Suresh Babu Sayana Associate Professor, Department of Pharmacology, Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i9.2065

Keywords:

Hypertension, Type 2 Diabetes Mellitus, Medication Adherence, Urban Slums, Compliance

Abstract

Background: Medication adherence is essential for effective management of chronic conditions such as hypertension and type 2 diabetes mellitus. In urban slum populations, adherence is often hindered by socioeconomic limitations, low health literacy, and lack of awareness, contributing to poor clinical outcomes.

Objective: This study aimed to evaluate the prevalence of medication adherence among individuals with hypertension and type 2 diabetes mellitus, identify associated sociodemographic and clinical factors, and explore barriers to adherence.

Methods: A descriptive cross-sectional study was carried out in the urban slums of Amalapuram from January 2025 to June 2025. A total of 100 adult patients with both hypertension and type 2 diabetes were enrolled. Data regarding sociodemographic characteristics, clinical history, and treatment practices were collected using a pretested structured questionnaire. The 8-item Morisky Medication Adherence Scale (MMAS-8) was used to assess adherence levels. Descriptive statistics were applied to determine prevalence, while associations with influencing factors were explored.

Results: The mean age of participants was 54.2 ± 9.6 years, with females accounting for 56%. Most patients (71%) belonged to the lower socioeconomic class. The average duration of hypertension and diabetes was 7.3 ± 3.8 years and 6.1 ± 3.2 years, respectively. Adherence assessment revealed that 28% had high adherence, while 36% each showed medium and low adherence. Younger age (<50 years), female gender, higher education, shorter disease duration, and middle socioeconomic status were positively associated with better adherence. The main reasons for poor compliance were forgetfulness (44%), discontinuation after symptomatic relief (28%), financial constraints (15%), and adverse drug reactions (8%).

Conclusion: Medication adherence among patients with coexisting hypertension and diabetes in Amalapuram urban slums was suboptimal, with nearly three-fourths demonstrating medium or low compliance.

Recommendations: Regular patient counseling, routine adherence assessment, and ensuring affordable access to medicines are essential to improve compliance and reduce long-term complications.

Author Biographies

Dr. Nageswara Rao. T, Associate Professor, Department of Pharmacology, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India

is currently serving as an Associate Professor of Pharmacology at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, East Godavari District, Andhra Pradesh, India. He holds a doctoral degree in Medical Pharmacology from the prestigious Index Medical College and Research Institute, Madhya Pradesh. With over 16 years of teaching experience in various medical institutions, Dr. Nageswara rao has made significant contributions to the field of pharmacology. His academic work includes nine research publications in reputed national and international journals, including one article indexed in PubMed. His dedication to research and education continues to enrich the academic and clinical landscape of medical pharmacology.T.Nageswararao:https://orcid.org/0009-0005-1638-6897

B. Naga Ramesh, Tutor, Department of Pharmacology, Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India

is currently working as a Tutor in the Department of Pharmacology at Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India. His academic interests include experimental and clinical pharmacology, drug safety, and rational therapeutics. He is actively involved in teaching undergraduate medical students and contributing to research activities within the institution. His work reflects a commitment to advancing pharmacological education and promoting evidence-based medical practice.ORCID ID:https://orcid.org/0009-0007-3205-749X

Dr. S Suguna, Associate Professor, Department of Pharmacology, Government Medical College and General Hospital, Khammam, Telangana, India

Associate Professor and In-Charge Head, Department of Pharmacology, Government Medical College and General Hospital, Khammam, Telangana, India. Dr. S. Suguna has over 15 years of academic, clinical, and research experience in pharmacology. Her research interests span clinical pharmacology, pharmacogenomics, in-silico drug and protein design, and new therapeutic target discovery. She has contributed novel gene: protein sequences to international repositories such as NCBI, the European Gene Bank, and the DNA Data Bank of Japan.

She has published extensively in reputed national and international journals, with a focus on drug safety, rational therapeutics, and experimental pharmacology. Her research has been recognized with best research paper awards at both university and international conferences.

In addition to research, Dr. Suguna is an experienced educator, actively engaged in teaching undergraduate and postgraduate students. She has guided D.Pharm students clinically, supervised undergraduate and postgraduate university projects, and mentored ICMR-funded student research. She also serves as a clinical guide and examiner for academic and fellowship programs. She is a recipient of the Department of Health Research Fellowship in Transdisciplinary Research and contributes significantly to academic and ethical committees of her institution. Dr. Suguna remains committed to fostering rational drug use, promoting evidence-based medicine, and advancing scientific inquiry in pharmacology. ORCID ID: https://orcid.org/0000-0001-8874-3706

Dr. Suresh Babu Sayana, Associate Professor, Department of Pharmacology, Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India

is an Associate Professor of Pharmacology at Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India. He earned his Doctoral degree in Medical Pharmacology from the esteemed Krishna Institute of Medical Sciences Deemed University (KIMSDU), Karad, Maharashtra. With over 16 years of teaching experience in various government and private medical institutions across Andhra Pradesh, Karnataka, and Telangana, Dr. Sayana has made notable academic and research contributions. He has authored 60 international research publications, including 20 articles indexed in PubMed and 14 in Scopus-indexed impact factor journals. His core research interests lie in ethnopharmacology, cardiology, Internal Medicine, and pharmacological review literature. Dr. Sayana secured 2nd rank in the Telangana State Public Service Commission (TSPSC) recruitment for the post of Assistant Professor in 2019. He was honored with the Best Teacher Award by the Government of Karnataka for his excellence in medical education. In 2025, he received the distinguished Cureus Laureate Award from the Cureus Journal of Medical Science in recognition of his outstanding contributions to scientific research. Suresh Babu Sayana: https://orcid.org/0000-0003-4971-4007

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