Reasons for adherence with antihypertensive medication

Svensson, Staffan; Kjellgren, Karin; Ahlner, Johan; Säljö, Roger

doi:10.1016/s0167-5273(00)00374-0

Cited by 177 publications

(107 citation statements)

References 10 publications

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“…However, some nonadherent patients were found to have a misconception of their disease, and generally disliked taking any medication. [33][34][35] A further important result of the COMPASS study concerns patients' past cardiovascular experience.…”

Section: Compliance In Hypertensive Patientsmentioning

confidence: 99%

“…26,27 The most common interventions aimed to increase compliance focus on a patient's knowledge about the disease and/or treatment (W ¼ wisdom/ knowledge). [29][30][31][32][33][34][35] In most studies, patients with an enhanced understanding of the disease and its management have higher adherence rates, [29][30][31] whereas others could not find a clear knowledge-adherence relationship. 32 However, only 20% of hospital patients feel that they received enough and adequate information and education, and another 20% are completely unsatisfied with the information they received.…”

Section: Introductionmentioning

confidence: 99%

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The COMpliance PraxiS Survey (COMPASS): a multidimensional instrument to monitor compliance for patients on antihypertensive medication

Schoberberger

Janda

Pescosta³

et al. 2002

J Hum Hypertens

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Low compliance is suspected as a major reason for treatment failure in hypertensive patients. To identify patients with low compliance at the commencement of antihypertensive treatment, the compliance praxis survey (COMPASS) was utilised. A total of 161 physicians identified 2389 hypertensive patients treated by ACEinhibitor. The physicians rated the compliance of the patients at baseline and at 6-month follow-up prospectively. Standard care was given. The mean age of patients was 64.5 years (54.4% women). The baseline overall score of compliance was medium to high in 97.3% of patients. A quarter of all patients (24.7%) were described as having difficulties to follow lifestyle changes, 22.3% lacked sufficient social support, and 31.0% were unwilling to obtain additional information about illness and treatment. Patients who had received prior treatment for cardiovascular disease were less compliant than those who received first treatment within this study (P ¼ 0.05). Younger (Po0.01), male patients (Po0.01), and those without prior cardiovascular disease (Po0.001) were significantly more likely to stop the antihypertensive treatment without a doctor's recommendation. Doctors' rating of compliance at baseline correlated well with ongoing treatment at 6-month follow-up. In conclusion, the COMPASS survey questionnaire is a useful instrument for doctors to differentiate between patients who lack resources and to then counsel patients based on their individual needs.

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Section: Compliance In Hypertensive Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The COMpliance PraxiS Survey (COMPASS): a multidimensional instrument to monitor compliance for patients on antihypertensive medication

Schoberberger

Janda

Pescosta³

et al. 2002

J Hum Hypertens

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“…Nonadherence has been associated with misunderstanding of the condition, perceived improvement in health, worsening in health, general disapproval of medications and concern over side effects. 2,4 Many of the instances of patients not taking medicines to minimise side effects are pragmatic. 3 For the majority of patients who have no symptoms with hypertension, the fact that they do not feel unwell may encourage noncompliance.…”

Section: Introductionmentioning

confidence: 99%

Patient compliance in hypertension: role of illness perceptions and treatment beliefs

2004

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Despite many years of study, questions remain about why patients do or do not take medicines and what can be done to change their behaviour. Hypertension is poorly controlled in the UK and poor compliance is one possible reason for this. Recent questionnaires based on the self-regulatory model have been successfully used to assess illness perceptions and beliefs about medicines. This study was designed to describe hypertensive patients' beliefs about their illness and medication using the self-regulatory model and investigate whether these beliefs influence compliance with antihypertensive medication. We recruited 514 patients from our secondary care population. These patients were asked to complete a questionnaire that included the Beliefs about Medicines and Illness Perception Questionnaires. A case note review was also undertaken. Analysis shows that patients who believe in the necessity of medication are more likely to be compliant (odds ratio (OR)) 3.06 (95% CI 1.74-5.38), Po0.001). Other important predictive factors in this population are age ), Po0.001), emotional response to illness (OR 0.65 (0.47-0.90), P ¼ 0.01) and belief in personal ability to control illness (OR 0.59 (0.40-0.89), P ¼ 0.01). Beliefs about illness and about medicines are interconnected; aspects that are not directly related to compliance influence it indirectly. The self-regulatory model is useful in assessing patients health beliefs. Beliefs about specific medications and about hypertension are predictive of compliance. Information about health beliefs is important in achieving concordance and may be a target for intervention to improve compliance.

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“…The quality of provider-patient communication predicts treatment adherence. [21][22][23][24] Physician-nurse interactions are associated with patient mortality and readmissions. 25,26 Teamwork has been correlated with patient outcomes 27 and quality of care.…”

Section: Discussionmentioning

confidence: 99%