PHILIPPINE COLLEGE OF HEALTH SCIENCE INC.
MEDICATION ADHERENCE OF HYPERTENSIVE SENIOR CITIZEN
DURING THIS TIME OF PANDEMIC AT BARANGAY 647 SAN MIGUEL,
MANILA
A Thesis Proposal
Presented to the
College of Pharmacy
Philippine College of Health Science Inc.
In Partial Fulfillment
Of the Requirements of the Degree
Bachelor of Science in Pharmacy
By:
ANYOG, SAMUEL DANIEL C.
BULEG, FATHMA-SARAH R.
CRUZ, JAYSON IVAN
NASIR, NURAINA I.
SAMAN, FAISAH C.
SAMPAYAN, KIM G.
January 15, 2021
PHILIPPINE COLLEGE OF HEALTH SCIENCE INC.
ABSTRACT
Medication adherence is an important factor in the management of
chronic diseases, such as hypertension. Adherence to hypertensive
medications contributes to uncontrolled blood pressure that further leads
to severe cardiovascular problems. This study aimed to explore the
number of non-adherent patients and the contributing factors to
medication adherence and non-adherence in a local community of Brgy.
647 San Miguel Manila, Philippines. The “maintenance drugs” was the
only significant factor for the adherence of the hypertensive patients. In
conclusion, most of the participants were adherent to their medications
mainly due to their continuous use of prescribed maintenance drugs.
Keywords: Adherence, maintenance drugs, hypertensive
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TABLE OF CONTENTS
1.0 Introduction
1.1 Background of the Study
1.2 Research Objective
1.3 Research Question
1.4 Research Significance
1.5 Scope and Limitation
1.6 Definition of Terms
2.0 Review of Related Literature
2.1 Review of the Literature
2.2 Theoretical / Conceptual Framework
3.0 Methodology
3.1 Research Design
3.2 Participants / Subjects / Respondents
3.3 Sample size and Sampling Method
3.4 Intended Data Gathering Techniques
3.5 Instrument/s
3.6 Data Analysis
References
Appendix A: Timetable for Research (Gantt chart)
Appendix B: Budget Proposal
Curriculum Vitae
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CHAPTER 1
INTRODUCTION
In this time of pandemic, all people adjust their routine, adjust the way
they live accordingly to the rules of policy maker. The aim of this thesis is
to study the factors that may lead to the adherence of patients in their
medication, their medication compliance before COVID19 and during the
declaration of COVID19. The results will contribute the knowledge of
individual for managing their medication in this kind of new normal
situation.
Background of the Study
Adherence medication is being about to the patients and physicians.
This type of patient is generally taken a medication who prescribe by their
health care providers. The Patients who have a poor adherence to
medication regimens is common, it is worsening of disease, can cause
death of patients and also increasing health care costs.
Treatment regimens is optimizing and also improving the communications
between the physician and the patients. Taken of medications that
prescribe by the health care providers are important by controlling the
diseases or chronic conditions and also treating temporary conditions and
also the overall long-term health and well-being of the patients. This
therapy that determine of treatment success. The medication for
adherence may failure it can affect to the patients but also affect to the
health care provider’s system.
Medication adherence is defined by the World Health Organization
as "the degree to which the person’s behavior corresponds with the
agreed recommendations from health care providers” medication
mismanagement is growing the public concern, especially among the
elders, it is the major contributor to emergency hospitalization and nursing
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home placement.
Medication adherence has long been recognized as an important if it is
under addressed of barrier to patient health. It can be affects both quality
and length of life and also overall of the health care costs. No adherence
to medications has been correlated to up to 50% of treatment failures and
approximately 125,000 deaths and nearly has 25% of hospitalizations per
year in the United States. The medications of non-adherence the
substantial cardiovascular benefits from their medications to limited extent.
As we can see the medication has a reasonable likelihood of achieving the
most clinical benefit is 80%. Despite this threshold, the adherence rates
for many chronic disease medications are estimated at 50%-60%, it is
likely also the Corona Virus Disease 2019 (Covid19) we may see
worsening adherence therapy due to known factors affects adherence and
the others that are unique to what is happening currently. In order to
improve adherence, a variety of pharmacist-led interventions have been
developed into this situation it’s shown on how pharmacists can respond
to help the patients to take their medication effectively and how to prevent
worsening health outcomes. Even the most effective inventions achieved
only the modest positive effects. Somehow to be effective, interventions
should be targeted underlying barriers to the adherence developed in a
systematic manners and tailored to the specific features of target group
and the setting.
Research Objective
The main goal of the study is to discern how the senior citizens of
Barangay 647 San Miguel, Manila cope up with their condition specifically
hypertension during this time of pandemic and how adherent they are to
their anti-hypertensive medications despite of the worldwide dilemma.
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Specific objectives
1. The study aims to give interest and expand more of one's knowledge
with regards to medication adherence.
2. To gather factual and reliable information from the senior citizen
respondents of Barangay 647 San Miguel, Manila.
3. To identify what are the effects of the pandemic to the respondents'
course of treatment.
4. To determine how adherent are the senior citizens of Barangay 647
San Miguel, Manila to their anti-hypertensive medications despite of the
pandemic.
Research Question
There are lots of Senior Citizen taking their medicines improperly. It is
important to let them know how they can properly take their medicines and
how medicines react to them during this pandemic. It also helps the
patient to be more aware on taking prescribed medications.
[Link] is the demographic profile of the respondents?
• Name
• Age
• Gender
2. Senior Citizen do miss a dose and how often?
3. How did the pandemic affect the medication of Senior Citizens?
4. Does Senior Citizen’s in 151 San Miguel, Manila know that they are not
allowed to go outside during this Pandemic?
Research Significance
This study represents the importance of knowing how adherent our
senior citizens are when it comes to their medications. The researchers
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conducted this study to impart knowledge that adherence is very essential
during the course of treatment. Philippines is one of the countries where
many are suffering from poverty thus the researchers decided to conduct
a study that will help not only the Filipinos but also other interested people
all around the globe about our study. This study shows the efficacy of
communication between the health care professionals and the patient
about their medication and the barriers that results to non-adherence. The
success of this study will not only benefit the researchers but also the
people and the nation.
It improves services and treatments not just for you but also for future
generations. It helps develop new tests for diagnosis, treatments and
processes that could eventually help Senior Citizen's
Scope and Limitations
This study covers the place, number of senior and information of the senior
citizen who's suffering from hypertension in Barangay 647 San Miguel,
Manila. The aim of this study is to obtain fundamental information about how
the senior citizens of BRGY. 647 San Miguel, Manila, aging from 60 to 80
years old specifically, adhere to their antihypertensive medications in this time
of pandemic. The study also aims to encompass how the respondents cope
and adjust in this time of crisis while managing their hypertension and what
instructions are given to them by their respective physician to still attain a
quality and healthy life during the pandemic. On this kind of new normal,
interview is still a factor for us to get information
1.6 Definition of Terms
1. Disease-a disorder of structure or function in a human, animal, or plant,
especially one that produces specific signs or symptoms or that affects a
specific location and is not simply a direct result of physical injury. 8.
medication- a substance used for medical treatment, especially a
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medicine or drug.
2. Drugs-a medicine or other substance which has a physiological effect
when ingested or otherwise introduced into the body.
3. Health -is a state of complete physical, mental and social well-being
and not merely the absence of disease or infirmity.
4. Health care-the organized provision of medical care to individuals or a
community.
5. Hypertension- condition characterized by persistent elevated blood
pressure.
6. Medication adherence-the degree to which the person's behavior
corresponds with the agreed recommendations from a health care
provider.
7. Pandemic-an epidemic occurring worldwide, or over a very wide area,
crossing international boundaries and usually affecting a large number of
people.
[Link]-an epidemic occurring worldwide, or over a very wide area,
crossing international boundaries and usually affecting a large number of
people.
9. Patient-a person receiving or registered to receive medical treatment.
10. Treatment-medical care given to a patient for an illness or injury.
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CHAPTER 2
REVIEW OF RELATED LITERATURE
2.1 Review of Related Literature
This chapter includes the ideas, generalization or conclusion,
methodologies and others. Those that were included in this chapter helps
in familiarizing information that are relevant and similar to the present
studies. Also the synthesis of the art, gap bridged study and the theoretical
framework terms are defined conceptually and operationally for clarity. In
clinical practice, hypertension is often insufficiently managed, a major
explanation for this being poor patient adherence to therapy. The underlying
causes for weak adhesion are little understood. We set out to examine the
self-reported explanations for adhering to or following medical advice about
antihypertensive medication from hypertensive patients.
Foreign literature
The published literature identifies hundreds of determinants of non-
adherence. Unfortunately, serious drawbacks of the methodology used by
numerous studies demand that this list be revised. In particular, many
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studies do not indicate the relative importance of the 3 identified
components of patient adherence: initiation, implementation, and
discontinuation. For example, the WHO recommends that determinants be
classified in 5 dimensions (Sabate, 2003): socio-economic factors,
healthcare team and system-related factors, condition-related factors,
therapy-related factors, and patient-related factors, but provides little or no
closure in respect to outcome, and in particular, to the stage of adherence
process. Moreover, little information exists on the determinants of short-
term adherence for acute diseases vs. long-term adherence for chronic
diseases.
Local literature
According to Jay Jazul (2017). Medication adherence is an
important factor in the management of chronic diseases such as
hypertension. Non-adherence to antihypertensive medications contributed
to uncontrolled blood pressure that further leads to severe cardiovascular
problems. Cardiovascular risks and number of deaths were also increased
with poor adherence. According to a cross-sectional survey of
hypertensive outpatients in the Philippine General Hospital (PGH), one of
the contributing factors to uncontrolled hypertension was medication non-
adherence. Factors affecting non-adherence to medication were lower
socioeconomic level, low income, and chronic kidney disease. On the
other hand, patients with increased maintenance medications and those
receiving financial support appeared to be more adherent to hypertensive
medications. Hypertension has been one of the leading risk factors
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contributing to cardiovascular problems such as coronary heart disease,
stroke, heart failure, and end-stage renal disease. It is necessary to
elaborate the importance of medication adherence in hypertension
population in order to improve the healthcare of the patients involved.
2.2 Theoretical / Conceptual Framework
The framework was developed from literature review of medication
compliance and Chinese cultural belief/practices and critique of major
models of health behaviors in persons with chronic illness. Four constructs
shape the model: motivation, cultural health perceptions, modifying
factors, and cultural health care activities. Among these constructs,
cultural health perceptions and health care activities are especially
important because these address how Chinese immigrants perceive HTN
and antihypertensive treatments and how they manage HTN. Using a
culturally sensitive model is important to guide studies of medication
compliance in this population and to assist health care providers to
support compliance with antihypertensive treatments for Chinese
immigrants.
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CHAPTER 3
METHODOLOGY
3.1 Research Design
The study using a descriptive survey method use to assess
demographic profile such as age, and gender. A study wherein the senior
citizen we’re made to ask about how cope-up with their condition
specifically hypertension during this time of pandemic and how adherent
they are to their anti-hypertensive medications. Each one were ask to
answer the questionnaire provided. The forms were all to be collected at
the end of the day and enter the data into the computer for analysis.
3.2 Participants / Subjects / Respondents
The researchers agreed to distribute questionnaires that will be filled
by the respondents containing brief questions essential to this study. The
participants will be the senior citizens aging from 60 to 80 years old both male
and female from Barangay 647 San Miguel, Manila that are currently taking
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antihypertensive medications. Prior to the dustribution of questionnaires, the
researchers will assure to secure a consent from the authorities of the said
barangay to secure the safetyness of both the respondent and the
researchers and to assure the respondents that the information they will be
giving out will be confidential and will be used for academic purposes only.
3.3 Sample size and Sampling Method
This study aims to investigate the immediate impact of the COVID-
19 pandemic on taking anti-hypertensive and their lifestyle changes
among the resident of Brgy. 647 San Miguel, Manila aged 60 to 80 years
old and above. The respondents consisted of 100 Senior Citizen. Through
the help of the barangay officials of BRGY. 647 San Miguel, Manila, the
researchers found out that there are 100 senior citizens with hypertension in
the area. Likewise, this study will give focus only to those 100 senior citizen
with hypertension in BGRY. 647 San Miguel, Manila.
3.4 Intended Data Gathering Techniques
The researchers agreed upon to distribute the questionnaires to the
senior citizen respondents aging 60 to 80 years old in Brgy. 647 San Miguel,
Manila. The questionnaire contains 20 brief questions essential in data
gathering and analyzation. The researchers will use ordinary paper for the
questionnaires as the tool to obtain data. After the distribution of
questionnaires, a short interview will be conducted with the respondents to
confirm the data given to prevent false information and to interrogate further if
follow-up questions are required.
3.5 Instrument/s
The Illness Perception Questionnaire we conduct and revised to
measure the illness perception and the medical interview satisfaction
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scale of the patients that we used individual of their consultations.
Name- To know the identity of the respondents
Age- To know the gap age of each respondents
Gender- to denote a range of identities that do not correspond to
established ideas of male and female.
The questions were based on five point like-rt scale. For each item, senior
citizen rates themselves on a scale. “1-Agree 2-Disagree 3-Neither”
QUESTIONNAIRE
MEDICATION ADHERENCE OF HYPERTENSIVE SENIOR CITIZEN
DURING THIS TIME OF PANDEMIC AT BARANGAY 647 SAN MIGUEL,
MANILA
Directions: Fill up the following questions by putting a check (√) on the
following
choices.
Name: (Optional)___________________________________________
Age: 60-65 yrs old 66-70 yrs old
71-75 yrs old 76-80 yrs old
Gender: Male Female
1-Agree 2-Disagree 3-Neither
[Link] this time of pandemic, sometimes I forget to take 1 2 3
my medication.
Do you take specific medication for hypertension?
Are you adherent to take your medicines during
pandemic?
I have difficulty going to the hospital for regular check-up
during this time of pandemic.
Sometimes I have difficulty following the doctor's advice
when using only a cellphone.
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I always follow my doctor's advice on taking my medicine
even this time of pandemic.
I need to buy medicine online and then deliver it by Lalo
move or Grab.
Have you ever thought about stopping taking your
medicine? because you have difficulty buying online.
How difficult it is to take maintenance medication during
this period of pandemic?
I check my blood pressure every week.
I this time of pandemic I wanted to stop taking my
medicine.
Because of the increase fare, it’s not practical for me to
travel in the nearest drugstore.
13. Because of the high volume of Covid positive in our
area, I don’t want risk myself going out to buy medicine.
There are times that I feel good and doesn't feel need of
taking medicine.
There are times that instead of buying medicine I’d rather
buy food for my family.
In this time of pandemic, I need to double my effort in
making money so that I can afford to have me
maintenance.
In this time of pandemic, health is my priority.
In this time of pandemic, I change my life style for the
better.
In this time of pandemic, I avoid unhealthy foods.
I can’t afford my everyday medicine.
3.6 Data Analysis
Frequency counts and percentage were used to summarize the
demographic profile of the respondents. Frequency table of answers to
each questions were used as a basis for the opinion of the respondents to
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specific questions.
REFERENCES
PHILIPPINE COLLEGE OF HEALTH SCIENCE INC.
Appendix A:
Timetable for Research (Gantt chart)
PHILIPPINE COLLEGE OF HEALTH SCIENCE INC.
Appendix B:
Budget Proposal
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Curriculum Vitae
Anyog, Samuel Daniel C.
0652 Jacob's Residence, Marzan Street Sampaloc Manila
Email: manganyog @[Link]
Mobile: 09062447195
PERSONAL INFORMATION
NAME: Samuel Daniel C. Anyog
AGE: 25years old
BIRTHDAY: January 26, 1995
BIRTHPLACE: Western Command Hospital
HEIGHT: 5’1
CITIZENSHIP: Filipino
CIVIL STATUS: Single
RELIGION: Roman Catholic
EDUCATIONAL ATTAINMENT:
COLLEGE:
2014-2017 ST. Jude College (Manila Campus)
Dimasalang Sampaloc Manila
Field: Bachelor of Science in Pharmacy
SECONDARY:
2007-2011 Puerto Princesa United Methodist School
Puerto Princesa City, Palwan
PRIMARY:
2001-2007 Immaculate Concepcion Parish Learning Center
Puerto Princesa City, Palwan
PHILIPPINE COLLEGE OF HEALTH SCIENCE INC.
FATHMA-SARAH R. BULEG
#151 San Agustin, St. San Miguel, Manila.
Mobile No.: 09667150647
Email: thmathmabuleg@[Link]’
Objective:
I’m familiar to drugs,medications and prescriptions, thus able to control
the risk of pharmacy [Link] my positive attitude and
strong ability of learning led to my outstanding academic achievement.
Educational Background:
Primary: Merry Child High School
Secondary: Manuel L. Quezon University
College: Philippine College Health in sciences, Inc.
Experience:
South Star Drug (Community Intern)
Compact Manufacturing (Manuf Intern)
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Jayson Ivan C. Cruz
Blk 142 Lot 20 Phase 4D, Narra Drive, Sto. Nino,
Meycauayan, Bulacan
0961 107 0965
jaysonivancc@[Link]
PERSONAL PARTICULARS
Birth Date: 4th of September, 1997
Birth Place: Manila
Status: Single
Height: 5’7” Ft. tall
Weight: 132 lbs
EDUCATIONAL BACKGROUND
TERTIARY LEVEL
Bachelor of Science in Pharmacy
Our Lady of Fatima University
McArthur Highway, Marulas, Valenzuela City
2015 – 2018
SECONDARY LEVEL
Trinitas College
Meycauayan, Bulacan
2010 – 2014
PRIMARY LEVEL
Saint Mary’s Academy of Sto. Nino
Sto. Nino, Meycauayan, Bulacan
2004 – 2010
WORKING EXPERIENCE
COMMUNITY INTERNSHIP
Pharmacy Preceptors Guild of the Philippines
October 2020 – December 2020
(Virtual Internship)
PHILIPPINE COLLEGE OF HEALTH SCIENCE INC.
Nuraina I. Nasir
4856 B, Int 2. Anahaw st. old [Link] manila 1016
09096973167
nhurznasir@[Link]
PERSONAL DATA
Birth Date: December 21, 1996
Birth Place: Tuburan Basilan
Status: Single
Height: 4’11 Ft. tall
Weight: 50kg
EDUCATIONAL BACKGROUND
TERTIARY LEVEL
Bachelor of Science in Pharmacy
Philipine Collge of Health Sciences, Inc.
2020-Present
SECONDARY LEVEL
Claret School of Lamitan
Lamitan, Basilan
2009-2012
PRIMARY LEVEL
Bato-bato Elementary School
Tuburan, Basilan
2005-2009
Experiences
Community Internship: Virtual PPGP
Hospital Internship: Mission Hospital
Manufacturing Internship: Medicamenta, Inc.
PHILIPPINE COLLEGE OF HEALTH SCIENCE INC.
Faisah C. Saman
+639167873870
79-A 14th Avenue Murphy Brgy Socorro, Cubao,
Quezon City
fhayenallyyy@[Link]
Personal Data: Date of Birth: June 29, 1996
Place of Birth: Marawi City
Nationality: Filipino
Sex: Female
Marital Status: Single
Religion: Islam
Experience: Community Internship (2014 – 2015)
TGP Generics Pharmacy
▪ LG 033 Lower G/F New Farmers Plaza, Cubao, Quezon
City, 1109 Metro Manila
Hospital Internship (2016 – 2017)
Perpetual Succor Hospital
836 Cayco St, Sampaloc, Manila, 1008 Metro Manila
Manufacturing Internship (2018 – 2019)
UK Derma Pharma Incorporation
1822 Blumentritt Extension, Sampaloc, 1000, Metro Manila
Education: Philippine College of Health Sciences (2019 – Present)
Bachelor of Science in Pharmacy
1813 Recto Ave, Sampaloc, Manila, 1008 Metro Manila
Arellano University (2014 – 2018)
▪ Bachelor of Science in Pharmacy
2600 Legarda St, Sampaloc, Manila, 1008 Metro Manila
SECONDARY
Rosevelt High School Cubao
2010-2014
PRIMARY
Lalabuan Elementary School
2009-2010
