Industry workers with hypertension and diabetes mellitus, the prevalence of self-reported adherence, and disease control

Castro, Priscila Ribeiro; Abreu, Roberta Mendes; Kochergin, Clavdia Nicolaevna; Medeiros, Danielle Souto de; Soares, Daniela Arruda; Louzado, José Andrade; Silva, Kelle Oliveira; Cortes, Matheus Lopes; Mistro, Sóstenes; Bezerra, Vanessa Moraes; Amorim, Welma Wildes; Oliveira, Márcio Galvão

doi:10.1590/s2175-97902022e20153

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Brazilian Journal of Pharmaceutical Sciences

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Article • Braz. J. Pharm. Sci. 58 • 2022 • https://doi.org/10.1590/s2175-97902022e20153 copy

Industry workers with hypertension and diabetes mellitus, the prevalence of self-reported adherence, and disease control

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

To evaluate the prevalence of self-reported drug adherence and factors associated, as well as clinical health outcomes, for industry workers with hypertension (HTN) and diabetes mellitus (DM). This was a cross-sectional study of 137 Brazilian industry workers with HTN and/ or DM. Self-reported adherence was assessed, and the disease control was defined through blood pressure and capillary glycemia values. Data were descriptively analyzed and the factors associated with adherence were evaluated using the Poisson model with robust variance to calculate prevalence ratios. The prevalence of self-reported drug adherence was 79.6% and the prevalence of disease control was 53.8%. There was no statistically significant association between the two variables. In the controlled disease group, non-adherence was associated with being under 40 years of age, not having a partner, and having a risky alcohol consumption habit. In the uncontrolled disease group, adherence was highest for participants aged 40 years and older. The prevalence of self-reported drug adherence was high, but the prevalence of disease control was low and not associated with adherence, indicating that the self-reported adherence measure may be inaccurate. Our findings identify some factors that explain non-adherent behavior in the workforce.

Keywords:
Drug adherence; Hypertension; Diabetes mellitus; Occupational health; workers; Brazil

Variables	Study population (%)	95% CI^a	Adherence (%)	PR^b	95%CI	p-value
Sociodemographic and economic variables
Sex						0.82
Male	75.2	67.2 - 81.8	80.0	1.02	0.83 - 1.26
Female	24.8	18.2 - 32.8	78.1	1
Age*						< 0.05
18 to 39 years	37.2	22.8 - 38.2	60.4	1
40 years or older	62.8	54.3 - 70.5	90.5	1.5	1.18 - 1.90
Race						0.32
Non-white	82.1	74.6 - 87.8	78.5	0.90	0.75 - 1.08
White	17.9	12.2 - 25.4	87.5	1
Education						0.24
High school/Technical school	40.7	32.7 - 49.3	78.8	1.08	0.86 - 1.36
Incomplete superior education or more^β	26.7	19.8 - 34.9	88.2	1.21	0.97 - 1.51
Illiterate/Complete fundamental school II^α	32.6	25.1 - 41.0	72.7	1
Marital status						0.08
With partner	73.7	65.6 - 80.5	83.0	1.21	0.94 - 1.55
Without partner	26.3	19.5 - 34.4	68.8	1
Family income*						<0.05
2 to <3 salaries^µ	23.0	16.6 - 30.9	65.5	0.74	0.56 - 0.98
<2 salaries	37.0	29.2 - 45.6	77.6	0.88	0.73 - 1.05
>= 3 salaries	40.0	32.0 - 48.6	88.5	1	0.95 - 1.37
Work shifts						0.85
Day/Night	80.9	73.3 - 86.7	80.8	1.02	0.83 - 1.26
Day	19.1	13.3 - 26.7	79.0	1
Work position						0.47
Manual labour	56.9	48.4 - 65.1	77.3	0.94	0.79 - 1.11
Non-manual labour	43.1	34.9 - 51.6	82.5	1
Habit and behaviour variables
Physical activity						0.86
Active	49.3	40.9 - 57.7	80.0	1.02	0.85 - 1.21
Inactive	50.7	42.3 - 59.1	78.8	1
Tobacco consumption						0.13
Yes	10.2	6.1 - 16.6	64.3	0.79	0.53 -1.18
No	89.8	83.4 - 93.9	81.4	1
Risky alcohol consumption*						<0.05
No	40.2	32.2 - 48.7	90.4	1.25	1.06 - 1.47
Yes	59.8	51.3 - 67.8	72.5	1
Health status variables
BMI ^c						0.99
Overweight	41.2	33.1 - 49.7	79.6	0.98	0.78 - 1.24
Obesity	38.2	30.4 - 46.8	80.4	0.99	0.79 - 1.26
Low/Normal	20.6	14.5 - 28.3	80.8	1
Presence of CVD ^d (angina, CHF ^e and infarction)						0.25
Yes	3.6	1.5 - 8.6	100	1.27	1.16 - 1.39
No	96.4	91.4 - 98.5	78.7	1
HAS and/or DM control						0.82
Yes	53.8	45.1 - 62.2	80.3	1.02	0.86 - 1.22
No	46.2	37.8 - 54.9	78.7	1
Self-evaluation of health
Regular	48.9	40.5 - 57.3	81.2	1.06	0.88 - 1.28	0.79
Bad/Very Bad	10.2	6.1 - 16.6	83.3	1.08	0.81 - 1.45
Good/Very Good	40.9	32.9 - 49.4	76.8	1
Health service variables
Health insurance						0.28
Yes	45.3	37.0 - 53.8	83.6	1.1	0.92 - 1.30
No	54.7	46.2 - 63.0	76.1	1
Last medical consultation
<1 year	69.8	61.5 - 77.0	80.7	1		0.58
≥1 year or never	30.2	23.0 - 38.5	76.3	0.95	0.77 - 1.16
Integrative practice user						0.96
No	89.0	82.5 - 93.3	79.5	1
Yes	11.0	6.7 - 17.5	80.0	1.01	0.77 - 1.32
Access to public health system drugs
No	50.9	41.3 - 60.5
Partial	16.1	10.1 - 24.4
Full	33.0	24.6 - 42.6

Variables	Controlled		p-value	Not controlled		p-value
Variables	Adherent (%)	Nonadherent (%)	p-value	Adherent (%)	Nonadherent (%)	p-value
Socio-demographic and economic variables
Sex			0.62			0.83
Male	81.2	18.8		77.8	22.2
Female	71.4	28.6		80.0	20.0
Age*			<0.05			<0.05
18 to 39 years	64.5	35.5		52.9	47.1
40 years or older	92.5	7.5		88.6	11.4
Race			0.59			0.38
Non-white	79.4	20.6		77.3	22.7
White	87.5	12.5		87.5	12.5
Education			0.8			0.27
High school/Technical school	78.6	21.4		79.2	20.8
Incomplete superior education or more^β	87.5	12.5		66.7	33.3
Illiterate/Incomplete fundamental school II^α	76.9	23.1		88.9	11.1
Marital status			<0.05			0.68
With partner	85.4	14.6		80.0	20.0
Without partner	62.5	37.5		75.0	25.0
Family income*			0.06			0.21
<2 salaries	84.6	15.4		69.6	30.4	0.24
2 to <3 salaries	61.1	38.9		72.7	27.3
> = 3 salaries	88.9	11.1		88.0	12.0
Work shifts			0.41
Day/Night	87.5	12.5		70.0	30.0	0.48
Day	78.2	21.8		80.0	20.0
Work position			0.48			0.7
Manual labour	77.8	22.2		76.7	23.3
Non-manual labour	84.6	15.4		80.6	19.4
Habit and behaviour variables
Physical activity			0.77			0.56
Active	78.8	21.2		81.2	18.8
Inactive	81.6	18.4		75.0	25.0
Tobacco consumption			0.69			0.07
Yes	75.0	25.0		50	50
No	81.0	19.0		81.8	18.2
Risky alcohol consumption*			<0.05			0.22
No	93.1	6.9		87.0	13.0
Yes	71.4	28.6		73.7	26.3
Health status variables
BMI ^a			0.91			0.96
Overweight	79.3	20.7		80.0	20.0
Obese	84.0	16.0		76.9	23.1
Low/Normal	81.2	18.8		80.0	20.0
Presence of CVD ^b (angina, CHF ^c , and infarction)			0.48			0.36
Yes	100	0		100	0
No	79.7	20.3		77.6	22.4
Self-evaluation of health			0.22			0.51
Regular	88.2	11.8		73.3	26.7
Bad/very bad	80.0	20.0		100	0
Good/very good	70.4	29.6		82.8	17.2
Health service variables
Health insurance			0.17			0.91
Yes	87.5	12.5		79.3	20.7
No	74.4	25.6		78.1	21.9
Last medical consultation			0.35			0.86
<1 year	83.3	16.7		77.8	22.2
≥1 year or never	73.9	26.1		80.0	20.0
Integrative practice user			0.38			0.42
No	81.5	18.5		76.9	23.1
Yes	66.7	33.3		88.9	11.1

Universidade de São Paulo, Faculdade de Ciências Farmacêuticas Av. Prof. Lineu Prestes, n. 580, 05508-000 S. Paulo/SP Brasil, Tel.: (55 11) 3091-3824 - São Paulo - SP - Brazil
E-mail: bjps@usp.br

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[1] *Correspondence: P. R. Castro. Instituto Multidisciplinar de Saúde. Universidade Federal da Bahia. Rua Hormindo Barros, 58, Quadra 17, Lote 58, Bairro Candeias, Vitória da Conquista Bahia, 45029-094, Brasil. Phone: 55 77 988333620. E-mail: priscilac@ufba.br.