International Journal of Current Research and Review
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IJCRR - 6(10), May, 2014

Pages: 77-85

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FACTORS ASSOCIATED WITH ADHERENCE TO ANTIHYPERTENSIVE TREATMENT AMONG PATIENTS ATTENDING A TERTIARY CARE HOSPITAL IN MANGALORE, SOUTH INDIA

Author: Nithin Kumar, Bhaskaran Unnikrishnan, Rekha Thapar, Prasanna Mithra, Vaman Kulkarni, Ramesh Holla, Darshan Bhagawan, Ishita Mehta

Category: Healthcare

Abstract:Background: Adherence to antihypertensive medication is very important in preventing complications. Objectives: To assess the level of adherence of hypertensive patients to their anti-hypertensive medications and to study the various factors influencing the adherence among these patients. Methodology: 120 hypertensive patients were interviewed using a pre-tested semi-structured questionnaire. The Morisky 8-Item Medication Adherence scale was used. Univariate and multivariate analysis was done to determine the factors associated with good adherence. Results: The mean age of study participants was 58.41 +/- 14.4 years. 45.8% of the participants had low level of adherence. On Univariate analysis, not experiencing any side-effects, provision of free medication and regular checkups were found to be significantly associated good adherence. None of the factors were found to be statistically associated with adherence on multivariate analysis. Conclusion: The level of adherence to treatment among the participants can be achieved through better health promotion and education strategies.

Keywords: Adherence, Antihypertensive medications, Morisky scale, Patient related factors, Health system related factors, Mangalore

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INTRODUCTION

Hypertension or high blood pressure is defined as having persistent, elevated systolic blood pressure of 140 mmHg or above and/or diastolic blood pressure of 90 mmHg or above.[1] It is rapidly emerging asa global public health challenge because of its high prevalence, especially in middle and low income countries. The risk for cardiovascular diseases including coronary artery disease, congestive heart failure, stroke (ischemic and haemorrhagic), renal failure and peripheral arterial disease increases two-fold in the presence of hypertension.[2]. Itis oneamong the leading risk factors for cardiovascular mortalityand accounts for 9.4 million deaths globally and 7 per cent of disability adjusted life years (DALYs) in 2010. The prevalence of hypertension in India is estimated to be around 20% - 40% in urban and 12% -17% in rural areas. It is also alarming to notice that more and more young adults are being diagnosed with hypertension. [3]According to a World Health Organization (WHO) report, the prevalence of hypertension in India among men and women aged 25 years or more was 23.1% and 22.6% respectively.[4]

Regular blood pressure monitoring and continuous treatment for control of hypertension can improve this scenario.Adherence to medication is very important to keep high blood pressure under check and prevent complications. The available evidence shows that reduction of blood pressure is associated with significant decrease in the incidence of stroke, ischemic heart disease, congestive heart failure, and renal failure, irrespective of age, gender, race or ethnicity, type of antihypertensive used, or severity of hypertension.[5] However adherence to antihypertensive medication is an issue of concern and poses a serious challenge to clinicians, and healthcare systems because of the mounting evidence that non adherence is prevalent.[6] Non adherence to long term medication for chronic diseases is a complex process and a complicated issue affecting patients? health, health expenditure, and resources? utilization. Non- adherence to antihypertensive medication is one of the main reason for failure to control blood pressure among those on treatment and is generally associated with bad outcomes of the disease. [7] Adherence has been often used interchangeably with the term „compliance?. However, the term adherence is preferred over compliance because the former implies an interactive, collaborative relationship between the patient and the care-giver. [8] Complianceis defined as the extent to which a person?s medication-taking behaviour coincides with the healthcare providers? medical advice and relies on patient obedience.[8,9] WHO defines adherence as ''the extent to which aperson's behaviour in taking medication, following a diet , and /or executing lifestylechanges corresponds with agreed recommendations from a health care provider.It is observed that patient adherence to treatment can be influenced by socioeconomic factors, health system and health care related factors, medication and disease related factors and finally, patient related factors.[10] The problem of non-adherence may not be limited to developing countries only, but its impact in developing countries like India is higher given the paucity of health resources and inequities in access to health care. Due to poor adherence it is inevitable that patient lands up with medical complications resulting, in himspending large amount of money on hospitalization and chronic illness care [6, 10] Even though adherence to medication can be measured using indirect methods like pill counts, pharmacy refill rates and electronic medication monitors it is rarely practiced in clinical care. [11] Self-reporting questionnaires with high validity and reliability have also been developed to measure the level of adherence to antihypertensive medication. [11, 12, 13]. However, ensuring patient adherence to therapy still remains a challenge for practitioners. Hence medication adherence has been called “The next frontier in quality improvement”and is anintegral part of cardiovascular outcomes research.[6,14] The present cross-sectional study was conducted to assess the level of adherence and the factors influencing adherence among hypertensive patientsin Coastal South India.

METHODOLOGY

This cross-sectional study was conducted among the hypertensive patients attending the peripheral outreach clinics belonging to the Department of Community Medicine, and the Medicine OPD at the hospital attached to Kasturba Medical College, Mangalore.The study participants were above 18 years of age and on anti-hypertensive treatment for more than 6 months. The sample size of 119 was calculated taking the level of adherence to antihypertensive medication as 60%. [15, 16, 17] with a relative precision of 15% and 95% confidence interval. Adding a non-response error of 10%, the sample size to be studied was 131.The data was collected using a pretested semi-structured questionnaire consisting of 4 sections: Section AParticipant?s general information, Section BDiagnosis and treatment details of hypertension, Section C - Health System related details and Section D -The Morisky 8-Item Medication

Adherence Questionnaireto assess the level of adherence to the anti-hypertensive medication. The questionnaire consists of a set of 8 questions with a yes or no answer. 1 point was awarded for every yes response and a zero for every no. A total score of >2 meant low adherence, 1 or 2 is medium adherence and a 0 shows high adherence.[18] Ethics Committee approval was obtained from the Institutional Ethics Committee of Kasturba Medical College, Mangalore (affiliated to Manipal University), India prior to the commencement of the study. After obtaining the required permission from the hospital/Medical college, the study participants were briefed about the nature and the purpose of the study, and were included in the study after taking a written informed consent. The socioeconomic status was assessed using the Kuppuswamy Scale. [20]

STATISTICAL ANALYSIS

The collected data was entered in, and analyzed using SPSS (Statistical Package for Social Sciences) version 11.5 (SPSS, Inc., Chicago, IL, USA). The data was analyzed in terms of descriptive statistics (Mean, Standard deviation and IQR) and the results were expressed in proportions. We undertook both unadjusted and adjusted logistic regression to assess the various (Patient related, Medication related and Health system related) factors favoring adherence to anti-hypertensive medication among patients. The fit of the logistic model was assessed with the Hosmer and Lemeshow goodness-of-fit test; P < 0.05 was considered evidence of a statistically significant difference between predictive and outcome variables. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) are reported

RESULTS

A total of 120 hypertensive patients were assessed about their level of adherence towards antihypertensive medication giving a response rate of 100%. The mean age of study participants was 58.4 +/- 14.4 years. Majority (n =76, 63.3%) of the participants were males and a higher proportion (n=66, 55.0%) were above 55 years of age. The family history of hypertension was present in 33.3% (n=40) of study participants. Comorbidities were present among 50.8% (n=61) of the participants of which Diabetes Mellitus (n=44, 72.1%) was the most common comorbid illness. The baseline characteristics of the study participants are shown in Table1. The mean duration of hypertension among the patients was 5 years (IQR 3-12) More than half (n=76, 63.3%) of the participants were diagnosed to be hypertensive in a private clinic. By self-report 116 (96.7%) of 120 patients were adherent to their anti-hypertensive medications. However on assessing the adherence level using Morisky scale it was observed that 54.2% of the participants had a medium level of adherence and 45.8% had poor level of adherence to their medication. There were no participants with high level of adherence to antihypertensive medication in our study. For the purpose of comparison, participants with medium level of adherence were considered to have a good adherence and those with low level of adherence were considered to be having poor adherence to medication. Table 2 shows the patient factors determininggood adherence to anti-hypertensive medication as measured by Morisky adherence scale.Adherence rate towards anti-hypertensive medications was better among participants above 60 years of age (57.4%)compared to those below 60 years (51.5%), (OR =0.8, CI= 0.4 – 1.6, p=0.520), but was not found to be statistically significant. Even though adherence rates were found to be better among married participants, those with positive family history of hypertension and among those who understood the doctor?s advice, none were found to be statistically significant in determining good adherence behaviour. Table 3 shows the medication related factors determining adherence to antihypertensive medications. Not experiencing any side-effects due to medicationwas found to be associated with good adherence and the association was found to be

statistically significant. (OR=0.1, 0.03-0.52, p=0.003) Table 4 shows the health system related factors determining good adherence to antihypertensive medications. Participants who were taking free medication were found to have better adherence towards their hypertensive medications and it was statistically significant. (OR=0.4,0.2-0.9,p=0.030) Even though on Univariate analysis, not experiencing any side-effects, provision of free medication and regular checkups were found to be significantly associated good adherence, on multivariate analysis none of the factors were found to be statistically associated with adherence. (Table-5)

DISCUSSION

Non-adherence to chronic disease medication is a major public health problem that has been called an "invisibleepidemic”. Reviews from developed countries such as the United States have shown that only 51% of the patients treated for hypertension adhere to the prescribed treatment where as in developing countries like China, Gambia and the Seychelles, only 43%, 27% and 26%, respectively, of patients adhere to their antihypertensive medication regimen.[10]The present study was conducted to assess the level of adherence to antihypertensive medication among the hypertensive patients in Mangalore, a Coastal city in South India. In our study by self-report 96.7% of the participants felt they were adherent to their prescribed medications. However on assessment using the Morisky scale 54.2% were found to have a moderate level of adherence to their hypertensive medication and 45.8% had a poor level of adherence.Our study findings are similar to studies from China [17] and Malaysia [11] where overall 52% and 53.4% of the participants were found to be adherent to their anti-hypertensive medication respectively. Similar studies from other parts of the globe have reported the prevalence of adherence to hypertensive medications to be ranging from 60% to 77%. [15, 16, 20-25].In a study in Birmingham, UK [26] only 44.8% of the participants were adherent to their hypertensive medication.The wide range inprevalence of adherence to antihypertensive medication across various studies may be due to the use of different scales to assess adherence. However there is no denying the fact that non-adherence to medication is a matter of huge concern. It is evident from our study as well as from others mentioned above; the problem of non-adherence is universal and not just limited to developed or developing countries.But its impact may be more onthose countries with limited resources since poor adherence poses a huge challengefor improving health in poor populations, and also results in underutilization of already limited treatment resources.[10] Various studies across countries have identified different factors influencing adherence to antihypertensive medication. In a study from Malaysia [11] females were found to be more adherent towards their medication compared to males, where as in UK [26]males were found to be more adherent towards medication which was similar to our study finding. Instudies from China [21] and Pakistan [25] age seemed to be an important factor influencing adherence with older patients being more adherent compared to younger patients. Similar observations were made in our study. The latter study also reported better awareness about the disease as an important factor for adherence towards medication which was also reported by study in Northwestern Ethiopia. [15] To add to this finding, in a study in Bangladesh[27] lack of information about the disease was an important factor for non-adherence to medication. The adherence was seen to be higher among patients on more medications. [16, 25].In a study in Greece [7], fear of complications of hypertension, personal relationship with the treating physician favored adherence.In the health system related factors the people who live closer to the hospital and those who get free drugs were seen to be more adherent to their medications than those who had to

come from a distance and had to pay for their drugs. Distance to the hospital as a factor which caused non adherence was also reported by other studies. [16, 24] Absence of any side effects to the medications, availability of free antihypertensive drugs and regular checkup of blood pressure were found to be associated with good adherence to antihypertensive medication in our study which were not found to be significant after multivariate analysis. On stratifying the factors, as well as those reported from other studies, the multifactorial nature of the problem of non-adherence is evident. Not one factor can be solely held responsible for influencing non-adherence among patients.The interventions planned to combat the problem should be targeted towards social, economic, medical, behavioral and health system related factors. The limitation of our study would be that the Morisky adherence questionnaire used in this study has not been validated in the Indian population. Also the sample size of our study is small to generalize the findings to a large extent. However there is a paucity of literature on adherenceto antihypertensive medications in the Indian subcontinent. We would like to recommend further studies in the region as well as across the country to assess the adherence level as well as the various factors influencing it. The clinicians should spend quality time with their patients and make them aware of the risk of complications arising from poor adherence to treatment. Health education plays an important role as well in creating awareness about the complications of hypertension among patients in general, with display of posters and flipcharts which can have an added effect. Patient self-help groups need to be formed and promoted where in the patients can discuss their reasons for non-adherence and try to solve it.The health system needs to be strengthened to make sure lack of medication is never a cause for non-adherence. The proposed National Programme on Prevention and Control of Diabetes, Cardiovascular diseases and Stroke (NPDCS) should address the issue of Non

adherence to medication and recognize it as one of modifiable risk factor for complications of hypertension. By preventing this risk factor, the qualities of life for individuals with hypertension can be improvedand will reduce the overall cardiovascular morbidity and mortality.

CONCLUSION

From our study, as well as those reported from other studies, the multifactorial nature of the problem of non-adherence is evident. Not one factor can be solely held responsible for influencing non-adherence among patients.The interventions planned to combat the problem should be targeted towards social, economic, medical, behavioral and health system related factors. The limitation of our study would be that theMorisky adherence questionnaire used in this study has not been validated in the Indian population. Also the sample size of our study is small to generalize the findings to a large extent. However there is a paucity of literature on adherence to antihypertensive medications in the Indian subcontinent. We would like to recommend further studies in the region as well as across the country to assess the adherence level as well as the various factors influencing it. The clinicians should spend quality time with their patients and make them aware of the risk of complications arising from poor adherence to treatment. Health education plays an important role as well in creating awareness about the complications of hypertension among patients in general, with display of posters and flipcharts which can have an added effect. Patient self-help groups need to be formed and promoted where in the patients can discuss their reasons for nonadherence and try to solve it. The health system needs to be strengthened to make sure lack of medication is never a cause for non-adherence. The proposed National Programme on Prevention and Control of Diabetes, Cardiovascular diseases and Stroke (NPDCS) should address the issue of Nonadherence to medication and recognize it as one of modifiable risk factor for complications of

hypertension. By preventing this risk factor, the qualities of life for individuals with hypertension can be improved and will reduce the overall cardiovascular morbidity and mortality.ACKNOWLEDGEMENTS The authors are grateful to the study participants who voluntarily took part in the study. We wish to acknowledge the support provided by the Department of Community Medicine, Kasturba Medical College, Mangalore and Manipal University for encouraging research and its publication in international journals of repute. Authors also acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.

 

References:

REFERENCES

1. NIH 2004. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Available at URL: http://www.nhlbi.nih.gov/guidelines/hypertensi on/jnc7full.pdf.Accessed on: 23/11/2013.

2. WHO 2013.A global brief on HypertensionSilent killer, global public health crisis. Available at URL:http://apps.who.int/iris/bitstream/10665/7 9059/1/WHO_DCO_WHD_2013.2_eng.pdf.Ac cessed on: 23/11/2013.

3. Mohan S, Campbell N, Chockalingam A.Time to effectively address hypertension in India.Indian J Med Res 2013; 137:627-631.

4. WHO 2012.World Health statistics 2012.Available at URL:http://www.who.int/gho/publications/worl d_health_statistics/EN_WHS2012_Full.pdf. Accessed on: 23/12/2013.

5. Chobanian AV. Impact of non-adherence to antihypertensive therapy. Circulation 2009; 120(16): 1558-60.

6. Ho PM, Bryson CL, Rumsfeld JS. Medication adherence: its importance in cardiovascular outcomes. Circulation 2009; 119(23):3028-35.

7. Tsiantou V, Pantzou P, Pavi E, Koulierakis G, Kyriopoulos J. Factors affecting adherence to antihypertensive medication in Greece: results from a qualitative study. Patient Prefer Adherence 2010; 4: 335-43.

8. Nichols – English G, Poirier S. Optimizing adherence to pharmaceutical care plans. J Am Pharm. Assn 2000; 40: 475 – 485.

9. Haynes RB, McDonald H, Garg AX, Montague P. Interventions for helping patients to follow prescriptions for medications. Cochrane Database Syst Rev 2002; 2: CD 000011.

10. WHO 2003.Adherence to long-term therapiesEvidence for action. Available at URL:http://whqlibdoc.who.int/publications/2003/9 241545992.pdf. Accessed on: 24/12/2013.

11. Ramli A, Ahmad NS, Paraidathathu T. Medication adherence among hypertensive patients of primary health clinics in Malaysia. Patient Prefer Adherence 2012 ; 6:613-22.

12. Koschack J, Marx G, Schnakenberg J, Kochen MM, Himmel W. Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties J ClinEpidemiol 2010 ;63(3):299-306.

13. Lambert EV, Steyn K, Stender S, Everage N, Fourie JM, Hill M. Cross-cultural validation of the hill-bone compliance to high blood pressure therapy scale in a South African, primary healthcare setting. Ethn Dis 2006; 16(1):286-91.

14. Heidenreich PA. Patient adherence: the next frontier in quality improvement.Am J Med. 2004; 117:130 –132.

15. Dessie A, Asres G, Meseret S, Birhanu Z Adherence to antihypertensive treatment and associated factors among patients on follow up at University of Gondar Hospital, Northwest Ethiopia. BMC Public Health 2012; 12:282.

16. Mweene MD, Banda J, Andrews B, Mweene MM, Lakhi S. Factors Associated With Poor Medication Adherence in Hypertensive Patients In Lusaka, Zambia. Med J Zambia 2010; 37:3.

17. Hsu YH, Mao CL, Wey M. Antihypertensive Medication Adherence among Elderly Chinese Americans. J TranscultNurs 2010; 21(4):297- 305.

18. Morisky8-Item Medication Adherence Questionnaire. Available at URL:http://media.mycme.com/documents/30/1 1-136_case_3_table_2_rev_7413.pdf. Accessed on: 23/11/2013.

19. Kumar BPR, Dudala SR, Rao AR. Kuppuswamy?s socio-economic status scale –A revision of economic parameter for 2012.Int Journal Res and Dev Health 2013; 1(1):2-4.

20. Lowry KP, Dudley TK, Oddone EZ, Bosworth HB. Intentional and unintentional nonadherence to antihypertensive medication. Ann Pharmacother. 2005; 39(7-8):1198-203.

21. Lee GK, Wang HH, Liu KQ, Cheung Y, Morisky DE, Wong MC. Determinants of medication adherence to antihypertensive medications among a Chinese population using Morisky Medication Adherence Scale. PLoS One 2013; 8 (4): e62775. doi:10.1371/journal.pone.0062775

22. Patel RP, Taylor SD. Factors affecting medication adherence in hypertensive patients.Ann Pharmacother 2002; 36 (1):40-5.

23. Atulomah NO, Florence MO, Oluwatosin A. Treatment adherence and risk of non-compliance among hypertensives at a Teaching Hospital in Ogun state, southwest Nigeria.acta SATECH 2010; 3(2):143- 149.

24. Chelkeba L, Dessie S. Antihypertension medication adherence and associated factors at Dessie Hospital, North East Ethiopia, Ethiopia. Int J Res Med Sci 2013;1(3):191-197.

25. Hashmi SK, Afridi MB, Abbas K, Sajwani RA, Saleheen D, Frossard PM et al.Factors associated with adherence to anti-hypertensive treatment in Pakistan. PLoS One. 2007 Mar 14;2 (3):e280.

26. Gohar F, Greenfield SM, Beevers DG, Lip GY, Jolly K. Self-care and adherence to medication: a survey in the hypertension outpatient clinic. BMC Complement Altern Med 2008; 8:4. doi: 10.1186/1472-6882-8-4.

27. SM Hussanin, C Boonshuyar, ARMS Ekram. Non-adherence to antihypertensive treatment in essential hypertensive patients in Rajshahi, Bangladesh. Anwer Khan Modern Medical College Journal 2011; 2(1):09-14.

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A Study by Kumar S. et al. entitled "A Study on Clinical Spectrum, Laboratory Profile, Complications and Outcome of Pediatric Scrub Typhus Patients Admitted to an Intensive Care Unit from a Tertiary Care Hospital from Eastern India" is awarded Best Article for Vol 13 issue 09
A Study by Mardhiah Kamaruddin et al. entitled "The Pattern of Creatinine Clearance in Gestational and Chronic Hypertension Women from the Third Trimester to 12 Weeks Postpartum" is awarded Best Article for Vol 13 issue 08
A Study by Sarmila G. B. et al. entitled "Study to Compare the Efficacy of Orally Administered Melatonin and Clonidine for Attenuation of Hemodynamic Response During Laryngoscopy and Endotracheal Intubation in Gastrointestinal Surgeries" is awarded Best Article for Vol 13 issue 07
A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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