Predicting blood pressure outcomes using single-item physician-administered measures: a retrospective pooled analysis of observational studies in Belgium

Abstract

METHOD Design and patientsData were pooled from five prospective, multicentre, pharmaco-epidemiological studies in which patients with hypertension, for whom first-line treatment either failed or was not tolerated, were treated for 90 days with one of several valsartan formulations as second-line therapy.Hypertension was defined as SBP of at ≥140 mmHg (≥130 mmHg for patients with concomitant diabetes) and/or DBP of ≥90 mmHg (≥80 mmHg for patients with concomitant diabetes). 9 The five studies had AimTo examine whether two simple, single-item physician-administered measures of patient adherence to antihypertensive medication are predictive of blood pressure outcomes. Design and settingRetrospective database analysis of patients with hypertension treated in Belgian primary care. MethodUsing pooled data from five observational studies, a sample was identified of 9725 patients who were assessed using two single-item physician-administered measures of adherence to antihypertensive medication: the first item of the Basel Assessment of Adherence Scale (BAAS) and the Visual Analogue Scale (VAS). These two assessment tools were administered by GPs during regular appointments with patients. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and combined SBP/DBP were measured at baseline and at 90 days. Results BAAS-identified ConclusionsThe first item of the BAAS and the VAS are independent predictors of blood pressure control. These methods can be integrated seamlessly into routine clinical practice by allowing GPs to quickly evaluate a patient's adherence and tailor treatment recommendations accordingly. Keywordshypertension; medication adherence; patient adherence; primary health care.Predicting blood pressure outcomes using single-item physician-administered measures:a retrospective pooled analysis of observational studies in Belgium

Adherence to antihypertensive medications and associations with blood pressure among African Americans with hypertension in the Jackson Heart Study

“…In addition, the 26% higher prevalence of uncontrolled BP in the non-adherent sample from the repeated measures multivariable adjusted analysis is comparable to the 20–50% higher prevalence reported in previous studies (35). Associations between single-item medication adherence measures and disease biomarkers have been reported previously (36–38). However, to our knowledge, no prior studies have used a self-report measure of antihypertensive medication non-adherence assessed over the prior 24 hours.…”

Hierarchical Modeling of Patient and Physician Determinants of Blood Pressure Outcomes in Hypertensive Patients with and without Diabetes: Pooled Analysis of Six Observational Valsartan Studies with 15,282 Evaluable Patients

“…Consistently, previous analyses have shown adherence to be a significant determinant of blood pressure outcomes and this single item has been shown to be highly predictive of outcomes [8]. Hence, this one study was not included in this pooled analysis.…”

A New Lebanese Medication Adherence Scale: Validation in Lebanese Hypertensive Adults

“…Association between adherence to medication and hypertension control has already been demonstrated [ 7 , 9 ]. LMAS-14 seems to be a better predictor of hypertension control in the Lebanese population; this could be due to taking into consideration the psychological and cultural factors.…”

“…In USA, 47% of all hypertensive patients and 60% of treated hypertensive patients had controlled blood pressure [ 6 ], compared to, respectively, 27% [ 2 ] and 48.9% [ 7 ] in Lebanon. Patients with uncontrolled blood pressure had a higher risk of nonadherence to their medication [ 8 ], while adherent patients had lower systolic blood pressure and diastolic blood pressure [ 9 ].…”