Selected factors affecting adherence in the pharmacological treatment of arterial hypertension

Abstract

BackgroundLow adherence to hypertension (HT) management is one of the major contributors to poor blood pressure (BP) control. Approximately 40%–60% of patients with HT do not follow the prescribed treatment. The aim of the study was to analyze the relationship between selected variables and adherence to hypotensive pharmacological treatment. Besides socioclinical variables, the study focused on the role of illness acceptance.Participants and methodsThe study included 602 patients with HT. Adherence and acceptance of illness were assessed using the following validated instruments: the Acceptance of Illness Scale (AIS) and the Morisky Medication Adherence Scale (MMAS).ResultsThe high-adherence group comprised a significantly higher percentage of patients with high illness acceptance scale scores than that of patients with low-to-moderate scores (42.4 vs 31.8%; P=0.008<0.01). The odds ratio (OR) showed that high adherence to pharmacological treatment was >1.5 times as likely to occur in the high acceptance group as in the low-to-moderate acceptance group (OR =1.58, 95% CI 1.14–2.19). Spearman’s rank correlation coefficients showed statistically significant correlations between adherence and sex (men ρ=−0.101; P=0.012), age >45–66 years (ρ=0.098; P=0.015), higher education level (ρ=0.132; P=0.001), grade ESC of HT (ρ=−0.037; P=0.057), receiving one-tablet polytherapy (ρ=0.131; P=0.015), and illness acceptance (ρ=0.090; P=0.024).ConclusionAcceptance of illness is correlated with adherence to pharmacological treatment, and consideration should be given to more widespread assessment of illness acceptance in daily practice. Male sex, age >45–66 years, duration of illness grade ESC of HT, and receiving one-tablet polytherapy are significant determinants of adherence to pharmacological treatment in HT.

Determinants of adherence to anti-hypertensive medications among adult hypertensive patients on follow-up in Hawassa Referral Hospital: A case–control study

“…In contrast, some researchers have also found better adherence among older patients, 23 in which patients in the age group of >40 but not > 60 and >65 were more adherent than younger age patients. 23,24 The better adherence to treatment found in elderly patients has been explained by the presence of co-morbidities, which make the patients perceive themselves as very ill and take the prescribed treatment seriously, and elderly patients in the study area might have received better care by their caregivers.…”

Individual factors increasing complexity of drug treatment—a narrative review

“…Sociodemographic characteristics like some age groups (younger than 65 years and older than 84 years) [53][54][55], not being partnered or married [56] or not having support in drug handling [47] and female sex [57] were related to nonadherence. Similarly, different levels of education (low as well as high levels of education) [58,59], poor numeracy [60] and low health literacy [15] were associated with nonadherence. Moreover, unemployment [31] and the income of the patient (low-class and middle-class income) [61,62] affected adherence negatively along with a busy lifestyle [28] and the use of alcohol [31] or illicit drugs [63].…”

Risk Factors for Low Pharmacy Refill Adherence Among Older Hypertensive Men and Women by Race

“…These results are consistent with previous reports. 6,33–36 Furthermore, sex-race stratification revealed that the associations between comorbidities and low antihypertensive medication adherence, and shorter hypertension duration and antihypertensive medication adherence found among all women were driven primarily by white women. While neither number of comorbidities nor duration of hypertension is “modifiable” in the context of a healthcare encounter, considering these risk factors may help providers to identify patients at risk for low antihypertensive medication adherence.…”