Medication Adherence and Treatment-Resistant Hypertension in Newly Treated Hypertensive Patients in the United Arab Emirates

Bhagavathula, Akshaya Srikanth; Shah, Syed M.; Aburawi, Elhadi H

doi:10.3390/jcm10215036

Cited by 11 publications

(10 citation statements)

References 43 publications

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“… 53 In a recent study conducted in the UAE among patients with hypertension, the overall adherence to antihypertensive treatment was 42% while we documented a higher rate at 78% with 85% at suboptimal hypertension control. 27 The UAE has an incidence for major CVD is 12.7 per 1000 person-years, 54 with 25% of this cohort positively affirming CVD. Almost all of this cohort are being treated (97%) at least 80% have indicated that their CVD event is controlled.…”

Section: Discussionmentioning

confidence: 99%

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Medication Adherence Among Patients with Multimorbidity in the United Arab Emirates

Allaham¹,

Feyasa²,

Govender³

et al. 2022

PPA

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Background Multimorbidity, defined as having two or more chronic diseases, has a major impact on public health and Sustainable Development Goals (SDG). This study aims to assess the prevalence of medication adherence and associated factors among patients with multimorbidity. Methods A questionnaire-based, cross-sectional survey was conducted by a trained interviewer across patients with multimorbidity attending outpatient clinics in two tertiary referral hospitals in the United Arab Emirates (UAE). Demographic and social variables and the outcome (self-reported adherence to long-term medication) were measured using the General Medication Adherence Scale (GMAS). Multiple logistic regression was used to assess medication adherence and associated factors. Results From a total of 630 participants included in this study, the estimated prevalence of high medication adherence is 78.57% (±1.63478) with a 95% confidence interval (CI) [75.19, 81.61]. The odds of high medication adherence increased with age. The odds of high medication adherence for patients aged 66 years and older than those aged 19–35 years is adjusted odds ratio (AOR) = 3.880, with a 95% CI [1.124, 13.390]. Patients with income more than 50,000 had the odds, AOR = 5.169 with a 95% CI [1.282, 20.843], compared to those earning less than 10,000 Dirhams (AED). Patients aged 36–65 with health insurance coverage had higher medication adherence than groups on the other end. The number of current medications is significantly (p-value = 0.027) associated with high medication adherence with the odds of high medication adherence, AOR = 4.529 with a 95% CI [1.184, 17.326], the highest for those currently taking four medications. Conclusion This study highlights younger population having multimorbidity in the context of an increasing life expectancy and suboptimal therapeutic outcomes. Furthermore, the study highlights multimorbidity is associated with low medication adherence and out-of-pocket payment, and non-availability of insurance is a major hindrance to medication adherence.

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Section: Discussionmentioning

confidence: 99%

“…25 Literature evidence suggests a higher rate of non-compliance with medications in patients with Diabetes 26 and Hypertension. 27 Medication compliance issues could lead to increased morbidity, mortality, and economic burden through hospitalization and increased costs due to chronic disease complications.…”

Section: Introductionmentioning

confidence: 99%

Medication Adherence Among Patients with Multimorbidity in the United Arab Emirates

Allaham¹,

Feyasa²,

Govender³

et al. 2022

PPA

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“…Although, treatment rates in Saudi Arabia are higher, compared with UAE and Iran (45% and 43%, respectively), the treatment rates in HICs were reported to be >70% [19,42]. Further, proportion of patients adhering to antihypertensive medications was reported to be low (22.5%) [22] similar to the ndings from other Middle Eastern countries like OPT (16.9%) [43], but was lower than UAE (42.0%) [44]. Likewise, a huge variation was observed in the proportion of patients achieving BP control (27.0%-45.0%) [10,19,23,24,29] while HICs including Canada and Germany reported higher BP control (50.0%-69.0%) [42].…”

Section: Hypertension: Gaps Along Patient Journey Touchpointsmentioning

confidence: 65%

Patient Journey for Hypertension and Dyslipidemia in Saudi Arabia: Highlighting the Evidence Gaps

Amir,

Alasnag,

Al-Raddadi

et al. 2022

Preprint

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Background In recent years, Saudi Arabia has witnessed staggering rates of hypertension and dyslipidemia- related cardiovascular (CV) deaths, overburdening the healthcare ecosystem of the country. Appropriate public health interventions can be devised through quantitative mapping of evidence. Identification of potential data gaps can prioritize future research needs and develop a ‘best-fit’ framework for patient-centric management of hypertension and dyslipidemia. Methods This review quantified data gaps in the prevalence and key epidemiological touchpoints of the patient journey including awareness, screening, diagnosis, treatment, adherence, and control in patients suffering from hypertension and dyslipidemia in Saudi Arabia. Studies published in English between January 2010–December 2021 were identified through a structured search on MEDLINE, Embase, BIOSIS and PubMed databases. An unstructured search on public and government websites including Saudi Ministry of Health without date limits was carried out to fill data gaps. After exclusion of studies based on pre-defined criteria, a total of 14 studies on hypertension, 12 studies and one anecdotal evidence for dyslipidemia were included in the final analyses. Results The prevalence of hypertension was reported to be 14.8–41.8% while that for dyslipidemia was 12.5–62.0%, respectively. The screening rate for hypertension was 100.0% as revealed by the nationwide surveys. Among hypertensive patients, only 27.6–61.1% patients were aware of their condition, 42.2% patients underwent diagnosis, 27.9–78.9% patients received antihypertension treatment, 22.5% patients adhered to treatment medication while blood pressure (BP) control was achieved in 17.0–45.0% patients. Likewise, among patients with dyslipidemia, 10.5–47.3% patients were aware of their condition, 34.6% patients were screened and 17.8% underwent diagnosis. Although high treatment rates ranging from 40.0–94.0% were reported, medication adherence recorded was 45.0–77.4% among the treated patients. The overall control rates ranged from 28.0–41.5%. Conclusions The study findings highlight evidence gaps along key touchpoints of patient journey touchpoints. Reinforcing the efforts for high-quality evidence-based research at a national level may pave a path for better resource utilization and provide guidance to practice and amend health policies for patients, healthcare practitioners (HCPs) and healthcare policy makers for better patient outcomes in Saudi Arabia.

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“…Adopting a lower BP threshold for hypertension (≥130/80 mmHg) and setting stringent target BP goals emphasizes the importance of early preventive measures and non-pharmacological interventions. Despite this, studies continue to record inadequate control of BP [ 20 , 23 , 24 , 28 , 29 , 30 , 31 ] and show poor physician compliance with such guidelines [ 32 , 33 , 34 ]. The continental divide of guideline-recommended BP goals is reflected in our study and showed variations in achievement across hypertensive subjects.…”

Section: Discussionmentioning

confidence: 99%

“…The study cohort, study population, inclusion and exclusion criteria, and baseline data including anthropometric and BP measurements were previously described in detail [ 24 ]. Briefly, a retrospective chart review was conducted to identify incident hypertensive adults registered for antihypertensive treatment across Abu Dhabi Health Services (SEHA) between 1 January 2017 and 31 December 2017, and each patient was retrospectively followed up for 6 months to assess their outcomes.…”

Section: Methodsmentioning

confidence: 99%

Hypertension Control and Guideline-Recommended Target Blood Pressure Goal Achievement at an Early Stage of Hypertension in the UAE

Bhagavathula

Shah

Suliman

et al. 2021

JCM

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(1) Background: The present study aimed to assess the changes in blood pressure (BP) within the first 6 months of treatment initiation in a newly treated hypertensive cohort and to identify the factors that are associated with achieving the target BP recommended by the American (ACC/AHA, 2017), European (ESC/ESH, 2018), United Kingdom (NICE, 2019), and International Society of Hypertension (ISH, 2020) guidelines. (2) Methods: We analyzed 5308 incident hypertensive outpatients across Abu Dhabi, United Arab Emirates (UAE), in 2017; each patient was followed up for 6 months. Hypertension was defined as a BP of 130/80 mmHg according to the ACC/AHA guidelines and 140/90 mmHg according to the ESC/ESH, NICE, and ISH guidelines. Multiple logistic regression was used to identify factors associated with achieving the guideline-recommended BP targets. (3) Results: At baseline, the mean BP was 133.9 ± 72.9 mmHg and 132.7 ± 72.5 mmHg at 6 months. The guideline-recommended BP targets were 39.5%, 43%, 65.6%, and 40.8%, according to the ACC/AHA, ESC/ESH, NICE, and ISH guidelines, respectively. A BMI of <25 kg/m2 was associated with better BP control according to the ACC/AHA (odds ratio (OR) = 1.26; 95% confidence interval (CI) = 1.07–1.49), ESC/ESH (OR = 1.27; 95% CI = 1.08–1.50), and ISH guidelines (OR = 1.22; 95% CI = 1.03–1.44). Hypertension treated in secondary care settings was more likely to achieve the BP targets recommended by the ACC/AHA (1.31 times), ESC/ESH (1.32 times), NICE (1.41 times), and ISH (1.34 times) guidelines. (4) Conclusions: BP goal achievement was suboptimal. BP control efforts should prioritize improving cardiometabolic goals and lifestyle modifications.

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Medication Adherence and Treatment-Resistant Hypertension in Newly Treated Hypertensive Patients in the United Arab Emirates

Cited by 11 publications

References 43 publications

Medication Adherence Among Patients with Multimorbidity in the United Arab Emirates

Medication Adherence Among Patients with Multimorbidity in the United Arab Emirates

Patient Journey for Hypertension and Dyslipidemia in Saudi Arabia: Highlighting the Evidence Gaps

Hypertension Control and Guideline-Recommended Target Blood Pressure Goal Achievement at an Early Stage of Hypertension in the UAE

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