The association between Self-Reported Medication Adherence scores and systolic blood pressure control: a SPRINT baseline data study

Abstract

We examined baseline data from the Systolic Blood Pressure Intervention Trial (SPRINT) to investigate whether medication adherence, measured by the Morisky Medication Adherence Scale (MMAS-8), was associated with systolic blood pressure (SBP), and whether MMAS-8 score and number of antihypertensive medications interacted in influencing SBP. 8,435 SPRINT participants were included: 21.2% had low adherence (MMAS-8: <6); 40.0% had medium adherence (6 to <8); and 38.8% had high adherence (8). SBP was <140 mmHg in 54.6%; 140 – 160 mmHg in 36.6%; and >160 mmHg in 8.8%. In multivariable regression, medium vs. low adherence weakly associated with lower SBP (OR: 1.17, CI: 1.04, 1.31). SPRINT eligibility criteria should be considered when interpreting results. Efforts to understand and enhance adherence are crucial to improve population health and using self-report instruments might be considered for predicting treatment adherence and response in future efficacy trials and for identifying patients for adherence support in clinical practice.

Self-Reported Medication Adherence Measured With Morisky Medication Adherence Scales and Its Determinants in Hypertensive Patients Aged ≥60 Years: A Systematic Review and Meta-Analysis

“…Among the 13 eligible studies, there were 11 conducted with the MMAS-8 (Berni et al, 2011 ; Holt et al, 2013 ; Lee et al, 2013 ; Muntner et al, 2013 ; Kang et al, 2015 ; Haley et al, 2016 ; Hou et al, 2016 ; Jankowska-Polańska et al, 2016 ; Okello et al, 2016 ; Al-Ruthia et al, 2017 ) and two in which the MGL Medication Adherence Scale was used ( Table 1 ) (Arshad, 2015 ; Teshome et al, 2017 ). Seven of those studies were conducted in Western countries: United States ( n = 4) (Holt et al, 2013 ; Muntner et al, 2013 ; Haley et al, 2016 ; Al-Ruthia et al, 2017 ), Poland ( n = 2) (Jankowska-Polańska et al, 2016 , 2017 ), and Italy ( n = 1) (Berni et al, 2011 ), and six in other countries: Hong Kong ( n = 2) (Lee et al, 2013 ; Kang et al, 2015 ), China ( n = 1) (Hou et al, 2016 ), Pakistan ( n = 1) (Arshad, 2015 ), Ethiopia ( n = 1) (Teshome et al, 2017 ), and Uganda ( n = 1) (Okello et al, 2016 ).…”

Cost-Effectiveness of Intensive versus Standard Blood-Pressure Control

“…Scenario analyses examined the effect of various assumptions with respect to medication adherence (including self-reported adherence, as measured in SPRINT with the use of an eight-item Morisky adherence scale 24,25 ), a restricted time horizon, the risk of death from causes other than cardiovascular disease, the number of office and laboratory visits, the risk of serious adverse events, the costs of antihypertensive medication and background health care, a substitution of the characteristics of SPRINT-eligible adults in the general U.S. population, 26 alternative utility estimates, and pill-taking disutility (i.e., the overall health state [utility value] of daily pill-taking) (Tables S3 and S5 in the Supplementary Appendix). To reassess cost-effectiveness in case the Pooled Cohort risk equations underestimated the risk of repeated cardiovascular disease events, we included a scenario that substituted a higher average risk of such events as predicted by the Framingham Recurrent Coronary Heart Disease calculator.…”

Adherence to riluzole in patients with amyotrophic lateral sclerosis: an observational study

“…An important worldwide public health problem in the management of chronic diseases is the medication adherence and persistence. Adherence is defined as “the extent to which a patient acts in accordance with the prescribed interval and dose of a dosing regimen.” 11 Adherence has been studied in many chronic illnesses, such as HIV infection, 12 hypertension, 13 diabetes, 14 epilepsy, 15 multiple sclerosis 16 and psychiatric disorders. 17 Overall, an average adherence of only 50% is indicated by the World Health Organization among patients with chronic diseases.…”