Improving Medication Adherence in Patients with Hypertension: A Randomized Trial

Hedegaard, Ulla; Kjeldsen, Lene Juel; Pottegård, Anton; Henriksen, Jan Erik; Lambrechtsen, Jess; Hangaard, Jørgen; Hallas, Jesper

doi:10.1016/j.amjmed.2015.08.011

Cited by 95 publications

(100 citation statements)

References 34 publications

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“…Studies have suggested that across both developed and LMIC countries there are considerable problems with adherence to antihypertensive medicines [18][19][20][21][22][23]. Overall, only approximately 14 to 25 % of treated patients achieve optimal blood pressure control, with 50 % of patients appearing to stop taking their antihypertensive treatments within the first year [24,25].…”

Section: Introductionmentioning

confidence: 99%

Patient-related beliefs and adherence toward their medications among the adult hypertensive outpatients in Tanzania

et al. 2017

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This version is available at https://strathprints.strath.ac.uk/59545/ Strathprints is designed to allow users to access the research output of the University of Strathclyde. Unless otherwise explicitly stated on the manuscript, Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Please check the manuscript for details of any other licences that may have been applied. You may not engage in further distribution of the material for any profitmaking activities or any commercial gain. You may freely distribute both the url (https://strathprints.strath.ac.uk/) and the content of this paper for research or private study, educational, or not-for-profit purposes without prior permission or charge.Any correspondence concerning this service should be sent to the Strathprints administrator: strathprints@strath.ac.ukThe Strathprints institutional repository (https://strathprints.strath.ac.uk) is a digital archive of University of Strathclyde research outputs. It has been developed to disseminate open access research outputs, expose data about those outputs, and enable the management and persistent access to Strathclyde's intellectual output. AbstractIntroduction: Hypertension is a leading global health problem requiring lifelong treatment. However, adherence to antihypertensive medicines is a problem, higher among developing countries. Consequently, there is a need to determine current adherence rates and their associations among developing countries to plan future initiatives. Methods: Cross-sectional study among adult outpatients with essential hypertension in Tanzania. Pre-designed questionnaires were used to gather information on adherence rates and patient-related beliefs. The main outcome measure was adherence. Results: 180 participants were included, with females making up 65%. High adherence rates in 54% of patients. Patients' belief about their medication and its necessity were higher in the high adherent group and concerns about their medicines and their necessity higher in the low adherent group. Conclusion: Adherence rates were low compared to a suggested level ≥ 80 %.

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Section: Introductionmentioning

confidence: 99%

Patient-related beliefs and adherence toward their medications among the adult hypertensive outpatients in Tanzania

et al. 2017

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“…AHM adherence, defined as the extent to which patients take medications as prescribed by their physicians, is also an important determinant for the preventative effect of AHM for stroke . Previous studies have reported that poor adherence to AHM appeared to be associated with an increased risk for stroke incidence or recurrence in patients with hypertension . However, inconsistent findings were retrieved for previous studies evaluating the association between AHM adherence and the risk of stroke.…”

Section: Introductionmentioning

confidence: 99%

Adherence to Antihypertensive Medications and Stroke Risk: A Dose‐Response Meta‐Analysis

et al. 2017

JAHA

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BackgroundInconsistent findings have been obtained for previous studies evaluating the association between antihypertensive medication (AHM) adherence and the risk of stroke. This dose‐response meta‐analysis was designed to investigate the association between AHM adherence and stroke risk.Methods and ResultsMEDLINE and Embase databases were systematically searched to identify relevant studies. The quantification of adherence to AHM was calculated as the percentage of the sum of days with AHM actually taken divided by the total number of days in a specific period. Summary relative risks (RR) and 95% CIs were estimated using a random‐effects model. Stratified and dose‐response analyses were also performed. A total of 18 studies with 1 356 188 participants were included. The summary RR of stroke for the highest compared with the lowest AHM adherence level was 0.73 (95% CI, 0.67–0.79). Stratified by stroke subtype, a higher AHM adherence was associated with lower risks of ischemic stroke (RR, 0.74; 95% CI, 0.69–0.79) and hemorrhagic stroke (RR, 0.55; 95% CI, 0.42–0.72). Moreover, both fatal (RR, 0.51; 95% CI, 0.36–0.73) and nonfatal stroke (RR, 0.52; 95% CI, 0.28–0.94) were lower in participants with higher AHM adherence. The results of a dose‐response analysis indicated that a 20% increment in AHM adherence level was associated with a 9% lower risk of stroke (RR, 0.91; 95% CI, 0.86–0.96).ConclusionsHigher AHM adherence is dose‐dependently associated with a lower risk of stroke in patients with hypertension.

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“…The key elements on which pharmaceutical intervention was based were medicine-use review and a motivational conversation with the patient about treatment compliance, explaining the doubts and fears of the patient in relation to the pharmacotherapy and the development of the disease. Despite these efforts, there was no significant difference in blood pressure between the two groups or differences between the combined clinical endpoint of cardiovascular death, stroke, or acute myocardial infarction among patients in the control group [37]. In turn, the results of the Alberta Clinical Trial in Optimising Hypertension (RxACTION) indicate that additional expansion of pharmaceutical services to standalone Rx prescription drugs may have an impact on the effectiveness of clinical pharmaceutical care.…”

Section: Expanding Pharmacy Services -The Need For a Multidimensionalmentioning

confidence: 96%

The role of the pharmacist in the care of patients with cardiovascular diseases

et al. 2016

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Improving Medication Adherence in Patients with Hypertension: A Randomized Trial

Cited by 95 publications

References 34 publications

Patient-related beliefs and adherence toward their medications among the adult hypertensive outpatients in Tanzania

Patient-related beliefs and adherence toward their medications among the adult hypertensive outpatients in Tanzania

Adherence to Antihypertensive Medications and Stroke Risk: A Dose‐Response Meta‐Analysis

The role of the pharmacist in the care of patients with cardiovascular diseases

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