Magnitude of Pharmacological Nonadherence in Hypertensive Patients Taking Antihypertensive Medication from a Community Pharmacy in Spain

Perseguer-Torregrosa, Zeneida; Orozco‐Beltrán, Domingo; Gil-Guillén, Vicente; Pita-Fernández, Salvador; Carratalá‐Munuera, Concepción; Pallarés‐Carratalá, Vicente; López-Pineda, Adriana

doi:10.18553/jmcp.2014.20.12.1217

Cited by 14 publications

(26 citation statements)

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“…(3) Although the treatment for hypertension control reduces morbidity and mortality, the effective control of disease is concerning because the proportion of hypertensive patients with controlled disease has varied around 50% worldwide. (4,5) As hypertension is a chronic disease, it requires continuous treatment, and the adequate control is directly related to the degree of adherence to antihypertensive therapy. (6) There is evidence that poor adherence affects the clinical evolution and quality of life of patients negatively, causing adverse outcomes such as increased morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Associação entre a qualidade de vida e adesão à medicação de indivíduos hipertensos

et al. 2015

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Objective: To evaluate the association between quality of life and medication adherence in hypertensive individuals. Methods: Cross-sectional study carried out with 432 hypertensive subjects registered in a federal public computerized system. Data were collected in the households through a structured interview with questions related to socioeconomic and clinical variables, as well as assessment of treatment adherence, and the WHOQOL-BREF for quality of life. The Kruskal-Wallis H test was used to measure the association between the scales of quality of life and the classification of treatment adherence. Results: The lowest scores were present in the self-assessment domain and the highest were found in the social domain. Individuals with extreme adherence to antihypertensive treatment showed higher scores in assessment of quality of life compared to individuals classified as extreme non-adherence to antihypertensive treatment. Conclusion:The association between quality of life and medication adherence in hypertensive patients was not predictive. The hypertensive subjects with high medication adherence showed the best scores of quality of life, and the worst scores were presented by individuals classified as extreme non-adherence and as borderline to total non-adherence. ResumoObjetivo: Avaliar a associação entre a qualidade de vida e a adesão a medicação de indivíduos hipertensos. Métodos: Estudo transversal, realizado com 432 hipertensos cadastrados em sistema informatizado público federal. Os dados foram coletados no domicilio por entrevista estruturada com questões relacionadas a variáveis socioeconômicas, clínicas, avaliação da adesão ao tratamento e o WHOQOL-BREF para a qualidade de vida. Utilizou-se o teste de H de Kruskal-Wallis para medir a associação entre as escalas da qualidade de vida e a classificação da adesão ao tratamento. Resultados: Os escores mais baixos estavam presente no domínio autoavaliação e os mais altos foram encontrados no social. Os indivíduos que possuíam adesão extrema ao tratamento anti-hipertensivo apresentaram escores mais altos na avaliação da qualidade de vida em comparação com indivíduos classificados como não adesão extrema ao tratamento anti-hipertensivo. Conclusão: A associação entre a qualidade de vida e adesão a medicação em indivíduos hipertensos não foi preditiva, sendo que os melhores escores estavam presentes nos indivíduos hipertensos que apresentaram alta adesão a medicação e os piores escores da qualidade de vida se apresentaram nos indivíduos de não adesão extrema e limítrofe a não adesão total.

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Section: Introductionmentioning

confidence: 99%

Associação entre a qualidade de vida e adesão à medicação de indivíduos hipertensos

et al. 2015

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“…To determine this variable, the ratio between the total number of tablets taken by the patient at follow-up and the total number of tablets prescribed by the doctor (obtained from the electronic prescription at the first visit) were calculated. We defined nonadherence as when the patient failed to take between 80% and 110% of the tablets prescribed by their physician (Perseguer-Torregrosa et al, 2014). …”

Section: Methodsmentioning

confidence: 99%

“…In addition, we studied NGRP of PPIs, because the presence of gastric symptoms (main recommendation of the guidelines) (Robinson & Horn, 2003; Domingues & Moraes-Filho, 2014; Administración de la Comunidad Autónoma del País Vasco, 2016) is an important factor associated with adherence (Dal-Paz et al, 2012; Lanas et al, 2012). Studies on other drugs have determined that the more prescriptions a patient has, the greater likelihood of treatment nonadherence (Perseguer-Torregrosa et al, 2014). The variable ‘prescription of antidepressants’ was included in the study because there was a suspicion that a depressed patient could have greater forgetfulness when taking the medication prescribed by his or her physician.…”

Section: Methodsmentioning

confidence: 99%

“…The first two methods are considered objective and allow accurate determination of whether the patient is nonadherent, but are difficult to apply in clinical practice. On the other hand, the Morisky test is not as accurate as the methods mentioned above and there must be a good doctor-patient relationship (Perseguer-Torregrosa et al, 2014). In other words, we do not have an objective measure that is easy to apply in clinical practice and that gives us accurate results, i.e., a screening test to determine nonadherence to PPI therapy.…”

Section: Introductionmentioning

confidence: 99%

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Construction, internal validation and implementation in a mobile application of a scoring system to predict nonadherence to proton pump inhibitors

Mares-García

Palazón‐Bru

Rosa

et al. 2017

PeerJ

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BackgroundOther studies have assessed nonadherence to proton pump inhibitors (PPIs), but none has developed a screening test for its detection.ObjectivesTo construct and internally validate a predictive model for nonadherence to PPIs.MethodsThis prospective observational study with a one-month follow-up was carried out in 2013 in Spain, and included 302 patients with a prescription for PPIs. The primary variable was nonadherence to PPIs (pill count). Secondary variables were gender, age, antidepressants, type of PPI, non-guideline-recommended prescription (NGRP) of PPIs, and total number of drugs. With the secondary variables, a binary logistic regression model to predict nonadherence was constructed and adapted to a points system. The ROC curve, with its area (AUC), was calculated and the optimal cut-off point was established. The points system was internally validated through 1,000 bootstrap samples and implemented in a mobile application (Android).ResultsThe points system had three prognostic variables: total number of drugs, NGRP of PPIs, and antidepressants. The AUC was 0.87 (95% CI [0.83–0.91], p < 0.001). The test yielded a sensitivity of 0.80 (95% CI [0.70–0.87]) and a specificity of 0.82 (95% CI [0.76–0.87]). The three parameters were very similar in the bootstrap validation.ConclusionsA points system to predict nonadherence to PPIs has been constructed, internally validated and implemented in a mobile application. Provided similar results are obtained in external validation studies, we will have a screening tool to detect nonadherence to PPIs.

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“…(11)(12)(13) The Batalla test consists of three questions and measures the adherence through the users' knowledge about their disease. Differently, the Morisky-Green test consists of four questions and measures adherence through the user's attitudes towards medication use.…”

Section: Methodsmentioning

confidence: 99%

Prevalência e fatores associados a cooperação do paciente portador de hipertensão arterial

et al. 2015

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Objective: To analyze the prevalence and factors associated with the cooperation of arterial hypertension patients in primary health care. Methods: Cross-sectional study that included 458 hypertensive patients, randomly selected among primary care users. The study variables were socioeconomic, demographic and clinical and the research instruments used were validated. The logistic regression model was used for multivariate statistical analysis. Results: The prevalence rates found for patient cooperation corresponded to 26.6%, 16.6% and 85.6% on the Morisky-Green, Batalla and Haynes-Sackett tests, respectively. The adjusted logistic regression analysis showed economic class and smoking as the independent predictors of hypertensive patients' cooperation. Conclusion: The prevalence of treatment adherence varied according to the assessment instrument used. The factors associated with treatment adherence were: high socioeconomic class, living with a partner and being eutrophic. ResumoObjetivo: Analisar a prevalência e os fatores associados a cooperação do paciente portador de hipertensão arterial na atenção primária. Métodos: Estudo transversal que incluiu com 458 hipertensos selecionados aleatoriamente entre os usuários na assistência primária. As variáveis de estudo foram socioeconômicas, demográficas e clínicas e os instrumentos de pesquisa utilizados eram validados. Foi utilizado o modelo de regressão logística para análise estatística multivariada. Resultados: As prevalências encontradas para cooperação do paciente foram 26,6%, 16,6% e 85,6% para os testes de Morisky-Green, Batalla e Haynes-Sackett, respectivamente. Análise de regressão logística ajustada mostrou classe econômica e fumo como os preditores independentes para a cooperação do paciente portador de hipertensão arterial. Conclusão: A prevalência de adesão ao tratamento variou de acordo com o instrumento de avaliação utilizado. Os fatores associados à adesão ao tratamento foram: classe socioeconômica elevada, morar com companheiro e ser eutrófico. Keywords

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Magnitude of Pharmacological Nonadherence in Hypertensive Patients Taking Antihypertensive Medication from a Community Pharmacy in Spain

Abstract: BACKGROUND: The most common factor associated with poor control of hypertension is treatment nonadherence to antihypertensive drug therapy.

Cited by 14 publications

References 44 publications

Associação entre a qualidade de vida e adesão à medicação de indivíduos hipertensos

Associação entre a qualidade de vida e adesão à medicação de indivíduos hipertensos

Construction, internal validation and implementation in a mobile application of a scoring system to predict nonadherence to proton pump inhibitors

Prevalência e fatores associados a cooperação do paciente portador de hipertensão arterial

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