Compliance with pharmacological therapy in hypertension: can we do better, and how?

Thrall, Graham; Lip, Gregory Y.H.; Lane, David

doi:10.1038/sj.jhh.1001722

Cited by 30 publications

(21 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the main reason for inadequate control of blood pressure is poor compliance with the treatment regimen, both pharmacological and behavioural. Understanding the reasons for patient noncompliance with antihypertensive medication is essential if blood pressure is to be more effectively managed (Thrall et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Determining the difference in medication compliance between the general patient population and patients receiving antihypertensive therapy: A case study

et al. 2011

View full text Add to dashboard Cite

This study addressed the issue of medication compliance in general, compliance with antihypertensive therapy, and the relationship between these two groups. In addition to determining the reasons for noncompliance with therapy prescription, the aim of this study was to also establish whether it was considered feasible by the patients to comply with their physician's instructions and whether the patients believed that the prescribed therapy was beneficial to their health. Hypertensive patients were compared to the total study population according to age groups. The study was designed as a cross-sectional survey with the use of a 33-item self-administered questionnaire. The study included 635 individuals who were collecting or buying drugs for the treatment of chronic diseases, with special reference to subjects taking antihypertensive agents (n = 361). More than half (n = 361; 56.9%) of the 635 study subjects were on therapy for arterial hypertension and possibly for some other diseases. The great majority of study subjects reported forgetfulness as the main reason for skipping drug doses. Comparison between the total study population and the subjects treated for arterial hypertension according to age groups (compliant, noncompliant and all together) yielded no statistically significant difference. We concluded that there was no difference in medication compliance between the general patient population and patients receiving antihypertensive therapy and there was no correlation between medication compliance and age.

show abstract

Section: Introductionmentioning

confidence: 99%

Determining the difference in medication compliance between the general patient population and patients receiving antihypertensive therapy: A case study

et al. 2011

View full text Add to dashboard Cite

show abstract

“…[8] Furthermore, non-compliance is the major reason for disease progression, the occurrence of complications, and failure of medical therapy. [9] Even clinical trials have indicated the importance of pharmacological treatment in decreasing the morbidity and mortality associated with cardiovascular diseases. [8] Hypertension is a "triple paradox": Easy to diagnose but often remains undetected; simple to treat but often remains untreated; despite the availability of drugs, treatment is not adequately effective.…”

Section: Introductionmentioning

confidence: 99%

A community-based study to assess the treatment adherence and its determinants among hypertensive patients residing in a rural area of Kancheepuram district, Tamil Nadu

Shrivastava¹,

Shrivastava²,

S³

2017

Int J Med Sci Public Health

View full text Add to dashboard Cite

the health-care delivery system in India. [1,2] Hypertension has been identified as the direct cause of deaths in more than 55% and 25% of all stroke and all coronary heart disease-related deaths reported in India.[3] Even on a global scale, hypertension is one of the most important causes of premature death as per the World Health Organization. [4] Current estimates reveal that hypertension affects more than 30% of adults with age 25 years and above which accounts for almost 1 billion people worldwide.[5] Furthermore, as per trend analysis, it has been estimated that more than 20 million cardiovascular deaths will be attributed to hypertension, by the year 2030, of which in excess of four-fifths will be from Background: Hypertension exerts a massive public health burden on cardiovascular health and health system in India. Objectives: The aim of this study is to assess the level of treatment adherence among the known hypertensive patients in a rural community and identify the determinants for non-adherence to treatment among them. Materials and Methods: A communitybased cross-sectional descriptive study was conducted for 2 months in Sembakkam and Kottamedu villages under the rural field practice area of a medical college among known cases of hypertension diagnosed and initiated on antihypertensive therapy at least 3 months back. A total of 170 hypertensive patients were included as study participants using random sampling, and the desired information was obtained using a semi-structured schedule, and details about treatment adherence based on the Morisky Medication Adherence Scale. Ethical clearance was obtained from the Institutional Ethics Committee before the start of the study. Written informed consent was obtained from the study participants before eliciting any information from them. Statistical analysis was done using SPSS version 18. Frequency distributions were calculated for all the variables. Chi-square test was used for testing the significance of association at P = 0.05. Results: Among the study participants, 81 (47.6%) had good medication adherence, whereas 89 (52.4%) had poor adherence. A statistically significant association was observed between indulging in regular physical activity and use of salt-restricted diet and a good level of treatment adherence. Poor adherence to treatment was found more commonly among patients who were prescribed multiple antihypertensive drugs and those with more than once daily dose formulation. Conclusion: The study indicates that prevalence of treatment adherence among hypertensive patients in rural areas of Tamil Nadu was only 47.6% and there is a lot of scope for improvement. The study has also identified the crucial factors responsible for non-compliance to antihypertensive treatment which can assist the health-care policy makers to formulate a comprehensive strategy to achieve adequate compliance.

show abstract

“…24 Studies shown no association of compliance with age and sex, but for literacy. 25 The present study has shown significant increase in compliance scores of all study subjects as well as in case of compliant and non-compliant patients after educating the patients about hypertension (Table 2, Figure 1) 19,20,21,[26][27][28][29] One study however could not find significant effect of education of hypertensive patients through mailing education packets, on mildly uncontrolled hypertension, but significant improvement in patient knowledge, home monitoring and satisfaction was observed. 30 In our study one to one verbal communication in the language of the patient probably proved more beneficial in improving compliance.…”

Section: Discussionmentioning

confidence: 99%

Impact of awareness about hypertension on compliance to antihypertensive medication

Gupta

Sood³

2018

Int J Basic Clin Pharmacol

View full text Add to dashboard Cite

INTRODUCTIONHypertension (defined as: systolic B.P.>=130mm Hg; diastolic B.P.>=80mm Hg) is a condition in which arterial B.P. is chronically elevated.1 It is the commonest cardiovascular disorder, posing a major public health challenge, a major risk factor for cardiovascular mortality and accounts for 20-50% of all deaths. 2 Raised blood pressure is responsible for 60% of strokes and 50% of coronary ABSTRACT Background: Hypertension, a common cardiovascular disorder accounts for 20-50% of all deaths. This risk can be greatly ameliorated by creating awareness about disease and its effective treatment alongside regular medical check-ups. Therapeutic failures result from patient non-compliance, manifested as intentional or unintentional errors in dosage or schedule, overuse or underuse of prescribed drugs and early termination of therapy. Adherence is helpful for management of hypertension and cost minimization. Non-adherence to the drug treatment is an important factor for uncontrolled hypertension and its complications. Methods: Patients were interviewed individually after taking informed consent, using pretested, predesigned, self-administered and closed ended questionnaire both before and 4 weeks after creating awareness about hypertension and its complications. Compliance measured by self-reporting in which knowledge of the patient about number of antihypertensive drugs being used, formulations of drugs, frequency of administration, duration of taking the drugs and knowledge of complications due to uncontrolled and untreated hypertension were assigned 1 score each. Patient having score of at least 4 out of total 5 was considered compliant. Results: No significant association of compliance with demographic and other variables like age, sex, marital status, economic status, education, urbanization, duration of treatment and drug procurement were noted. A significant increase in compliance in patients on antihypertensive medication was found 4 weeks after creating awareness about hypertension and its complication. A significant increase in compliance scores was also seen in non-compliant patients showing their shifting from non-compliance to compliance group. Overall compliance increased from 59.38% to 84.38%. A percentage decrease from 58.82% to 25% in patients having uncontrolled hypertension was also observed after the awareness about hypertension. Conclusions: Demographic variables, duration of hypertension and drug procurement have no significant effect on compliance to antihypertensive medication. There is persistence and improvement in compliance to antihypertensive medications after an education of the patients about hypertension and its complications.

show abstract

Compliance with pharmacological therapy in hypertension: can we do better, and how?

Cited by 30 publications

References 20 publications

Determining the difference in medication compliance between the general patient population and patients receiving antihypertensive therapy: A case study

Determining the difference in medication compliance between the general patient population and patients receiving antihypertensive therapy: A case study

A community-based study to assess the treatment adherence and its determinants among hypertensive patients residing in a rural area of Kancheepuram district, Tamil Nadu

Impact of awareness about hypertension on compliance to antihypertensive medication

Contact Info

Product

Resources

About