scholarly journals Measuring adherence to antihypertensive medication using an objective test in older adults attending primary care: cross-sectional study

2021 ◽  
Author(s):  
James P. Sheppard ◽  
Ali Albasri ◽  
Pankaj Gupta ◽  
Prashanth Patel ◽  
Kamlesh Khunti ◽  
...  
Keyword(s):  
Primary Care ◽  
Medication Adherence ◽  
Urine Sample ◽  
Antihypertensive Medication ◽  
Cross Sectional Study ◽  
Urine Samples ◽  
Sample Collection ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Adherence To Medication

AbstractAnalysis of urine samples using liquid chromatography-tandem mass spectrometry (LC-MS/MS) has previously revealed high rates of non-adherence to antihypertensive medication. It is unclear whether these rates represent those in the general population. This study aimed to investigate whether it is feasible to collect urine samples in a primary care setting and analyse them using LC-MS/MS to detect non-adherence to antihypertensive medication. This study used a prospective, observational cohort design. Consecutive patients were recruited opportunistically from five general practices in UK primary care. They were aged ≥65 years with hypertension and had at least one antihypertensive prescription. Participants were asked to provide a urine sample for analysis of medication adherence. Samples were sent to a laboratory via post and analysed using LC-MS/MS. Predictors of adherence to medication were explored with multivariable logistic regression. Of 349 consecutive patients approached for the study, 214 (61.3%) gave informed consent and 191 (54.7%) provided a valid urine sample for analysis. Participants were aged 76.2 ± 6.6 years and taking a median of 2 antihypertensive medications (IQR 1–3). A total of 27/191 participants (14.2%) reported not taking all of their medications on the day of urine sample collection. However, LC-MS/MS analysis of samples revealed only 4/27 (9/191 in total; 4.7%) were non-adherent to some of their medications. Patients prescribed more antihypertensive medications were less likely to be adherent (OR 0.24, 95%CI 0.09–0.65). Biochemical testing for antihypertensive medication adherence is feasible in routine primary care, although non-adherence to medication is generally low, and therefore widespread testing is not indicated.

scholarly journals Treatment adherence among patients with hypertension: findings from a cross-sectional study

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Fahad M. Algabbani ◽  
Aljoharah M. Algabbani
Keyword(s):  
Medication Adherence ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Adherence Rate ◽  
Sectional Study ◽  
Adherence To Treatment ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Adherence To Medication

Abstract Background Hypertension is a major risk factor for cardiovascular disease, which is the leading cause of mortality globally. Patient’s adherence to treatment is a cornerstone factor in controlling hypertension and its complications. This study assesses hypertension patients’ adherence to treatment and its associated factors. Methods This cross-sectional study conducted in Riyadh, Saudi Arabia. The study targeted outpatients aged ≥18 years who were diagnosed with hypertension. Participants were recruited using a systemic sampling technique. The two main measurements were assessing adherence rate of antihypertensive medications using Morisky scale and identifying predictors of poor medication adherence among hypertensive patients including socio-economic and demographic data, health status, clinic visits, medication side effects, medications availability, and knowledge. Descriptive and logistic regression analyses were performed to assess factors associated with poor adherence. Results A total of 306 hypertensive outpatients participated in this study. 42.2% of participants were adherent to antihypertensive medications. Almost half of participants (49%) who reported having no comorbidities were adherent to antihypertensive medications compared to participants with one or more than one comorbidities 41, 39% respectively. The presence of comorbid conditions and being on multiple medications were significantly associated with medication adherence (P-values, respectively, < 0.004, < 0.009). Patients with good knowledge about the disease and its complications were seven times more likely to have good adherence to medication (P <  0.001). Conclusions Non-adherence to medications is prevalent among a proportion of hypertensive patients which urges continuous monitoring to medication adherence with special attention to at risks groups of patients. Patients with comorbidities and on multiple medications were at high risk of medication non-adherence. Patients’ knowledge on the disease was one of the main associated factors with non-adherence.

scholarly journals Antiepileptic Drug Nonadherence and Its Predictors among People with Epilepsy

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Asmamaw Getnet ◽  
Solomon Meseret Woldeyohannes ◽  
Lulu Bekana ◽  
Tesfa Mekonen ◽  
Wubalem Fekadu ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Antiepileptic Drug ◽  
Health Information ◽  
Cross Sectional Study ◽  
Functional Restoration ◽  
Sustained Remission ◽  
Cross Sectional ◽  
Adherence To Medication ◽  
Adherence Scale ◽  
Consequent Reduction

Introduction. Antiepileptic drugs are effective in the treatment of epilepsy to the extent that about 70% of people with epilepsy can be seizure-free, but poor adherence to medication is major problem to sustained remission and functional restoration. The aim of this study was to assess the prevalence and associated factors of antiepileptic drug nonadherence. Methods. Cross-sectional study was conducted on 450 individuals who were selected by systematic random sampling method. Antiepileptic drug nonadherence was measured by Morisky Medication Adherence Scale (MMAS) and logistic regression was used to look for significant associations. Result. The prevalence of AEDs nonadherence was 37.8%. Being on treatment for 6 years and above [AOR = 3.47, 95% CI: 1.88, 6.40], payment for AEDs [AOR = 2.76, 95% CI: 1.73, 4.42], lack of health information [AOR = 2.20, 95% CI: 1.41,3.43], poor social support [AOR = 1.88, 95%, CI: 1.01, 3.50], perceived stigma [AOR = 2.27, 95% CI: 1.45, 3.56], and experience side effect [AOR = 1.70, 95% CI: 1.06, 2.72] were significantly associated with antiepileptic drug nonadherence. Conclusion. More than one-third of people with epilepsy were not compliant with their AEDs. Giving health information about epilepsy and its management and consequent reduction in stigma will help for medication adherence.

scholarly journals Older people's knowledge of the purpose of drugs prescribed at primary care appointments

2021 ◽  
Author(s):  
Romana Santos Gama ◽  
Luiz Carlos Passos ◽  
Welma Wildes Amorim ◽  
Renato Morais Souza ◽  
Hévila Maciel Queiroga ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Older People ◽  
Patient Adherence ◽  
Cross Sectional Study ◽  
High Rate ◽  
Cross Sectional ◽  
Adherence To Medication ◽  
Level Of Knowledge ◽  
Family Practice Physician

Rationale, aims and objectives: Patient adherence to medication is related to successful pharmacotherapy; however, many patients do not take their medications as prescribed because of poor understanding of their purpose.This study aimed to assess older people’s knowledge of the purpose of drugs prescribed at medical appointments in primary care units and the possible factors related to their level of knowledge about their medications. Method: This was a cross-sectional study conducted in 22 basic health units in Brazil. Older people from this sample who were treated in a primary care setting were interviewed after a consultation with a family practice physician. Data were collected from September 2016 to March 2019. Patients aged ≥ 60 years who visited the primary care units were included in the study (n = 674). Knowledge of prescribed medications was assessed by comparing the responses to the questionnaire and the medication and prescription information. Multivariate analyses were conducted using a Poisson regression with robust variance. Results: The mean age of the sample was 70.1 (standard deviation: ± 7.1) years. Among 674 patients, 272 (40.4%) did not know the indication of at least one of their prescribed drugs; among them 78 (11.6%) did not know the indication of any of their prescribed drugs. In the final multivariate analysis, polypharmacy, illiteracy, and cognitive impairment were found to be associated with misunderstanding the purpose of at least one prescribed drug. Moreover, illiteracy and cognitive impairment were associated with a greater misunderstanding of the purpose of all prescribed drugs. Conclusions: In the studied sample, patients demonstrated a high rate of misunderstanding of the purpose of prescribed drugs. Therefore, it is necessary for health services and professionals to implement strategies that increase the quality of the guidance and instructions given to older people in order to promote adherence to treatment.

scholarly journals Hypertension-related knowledge, medication adherence and health-related quality of life (HRQoL) among hypertensive patients in Islamabad, Pakistan

2021 ◽  
Vol 18 (5) ◽  
pp. 1123-1132
Author(s):  
Muhammad Amer ◽  
Nisar-Ur-Rahman ◽  
Saeed-Ur-Rashid Nazir ◽  
Atif Raza ◽  
Humayun Riaz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medication Adherence ◽  
Correlation Coefficient ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Adherence To Medication ◽  
Hypertension Knowledge

Purpose: To determine knowledge regarding hypertension, adherence to medication and HealthRelated Quality of Life (HRQoL), and their associations in hypertensive patients in Pakistan. Methods: A cross-sectional study was conducted among 384 hypertensive patients attending a tertiary health care public sector hospital in Islamabad, Pakistan. Data were collected using knowledge questionnaire regarding hypertension, Morisky Medication Adherence Scale, and EuroQol (EQ-5D) scale. Results: The mean systolic and diastolic blood pressures of the 384 patients were 140.39 ± 15.485 and 88.74 ± 10.683 mmHg, respectively. The coefficient of correlation between knowledge regarding hypertension and adherence was 0.638 (p < 0.001), showing a positive association. The correlation coefficient between knowledge and HRQoL was 0.709 (p < 0.001), suggesting a good association. The correlation coefficient between adherence to medication and HRQoL was 0.545 (p < 0.001), which indicated a positive correlation. Conclusion: These results indicate that there are statistically significant associations between hypertension knowledge and HRQoL, hypertension knowledge and medication adherence, and between adherence and HRQoL in the hypertensive patients studied.

scholarly journals Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Gabriel U.P. Iloh ◽  
John N. Ofoedu ◽  
Patrick U. Njoku ◽  
Agwu N. Amadi ◽  
Ezinne U. Godswill-Uko
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Medication Adherence ◽  
Antihypertensive Medication ◽  
Primary Care Clinic ◽  
Tertiary Hospital ◽  
Primary Hypertension ◽  
Detection Rates ◽  
Care Clinic ◽  
Adherence To Medication

Background: As the case detection rates of hypertension increase in adult Nigerians, achieving target blood pressure (BP) control has become an important management challenge.Objectives: To describe medication adherence and BP control amongst adult Nigerians with primary hypertension attending a primary care clinic of a tertiary hospital in a resource-poor environment in Eastern Nigeria.Methods: A cross-sectional study was carried out in 140 adult patients with primary hypertension who have been on treatment for at least 6 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have achieved goal BP control if the BP was < 140 per 90 mmHg. Adherence was assessed in the previous 30 days using a pretested researcher-administered questionnaire on 30 days of self-reported therapy. Adherence was graded using an ordinal scoring system of 0–4; an adherent patient was one who scored 4 points in the previous 30 days. Reasons for non-adherence were documented.Results: Adherence to medication and BP control rates were 42.9% and 35.0% respectively. BP control was significantly associated with medication adherence (p = 0.03), antihypertensive medication duration ≥3 years (p = 0.042), and taking ≥ one form of antihypertensive medication (p = 0.04). BP at the recruitment visit was significantly higher than at the end of the study (p = 0.036). The most common reason for non-adherence was forgetfulness (p = 0.046).Conclusion: The rate of BP control amongst the study population was low, which may be connected with low medication adherence. This study urges consideration of factors relating to adherence alongside other factors driving goal BP control.

A CROSS SECTIONAL STUDY OF TREATMENT INCLUDING LIFESTYLE MODIFICATION ADHERENCE IN PATIENTS WITH TYPE II DIABETES MELLITUS AND FACTORS AFFECTING TREATMENT ADHERENCE

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Niraimathi G ◽  
Sivaraman S
Keyword(s):  
Diabetes Mellitus ◽  
Medication Adherence ◽  
Treatment Adherence ◽  
Type Ii Diabetes ◽  
Cross Sectional Study ◽  
Hypoglycemic Agents ◽  
Type Ii ◽  
Sectional Study ◽  
Cross Sectional ◽  
Adherence To Medication

Diabetes mellitus is a growing cause of disease burden worldwide. In order to maintain the glycemic control, multifaceted management and pharmacotherapy are playing vital role. Data related to medication adherence among the affected patients are not much recorded in developing countries like India. In this study, the level of adherence and factor influencing non-adherence to diabetic medication among patients with type II diabetes was assessed. This is a hospital based cross sectional study among adult patients receiving diabetic care. The medication adherence was assessed using the Medication compliance questionnaire. Factors associated with non-adherence to medication were determined using basic and adjusted multivariable logistic regression models. A total of 101 patients with type II diabetes were recruited for this study. Most of the patients told that they practiced both aerobic exercises and diet along with their medication for diabetic management. Nearly 90% of the patients adherent to diet and maximum of 73% patients took oral hypoglycemic agents (OHA) alone followed both combination of OHA and insulin. Out of 101 patients, 67 had co-morbid psychiatric illness including mood disorders, neurotic stress and somatoform disorder. Adherence to treatment with diabetic is moderate in this study with more than half of participants being non-adherent. Urgent interventions are required to tackle this problem in combined efforts to stem this looming diabetes epidemic. Keywords: Diabetes mellitus, life style modifications, treatment adherence

scholarly journals Factors Affecting Adherence to Antihypertensive Medication: Results from a Rural Population Study in East of Iran

2016 ◽  
Vol 9 (5) ◽  
pp. 286 ◽  
Author(s):  
Reza Esmaeili ◽  
Mohammad Matlabi ◽  
Abduljavad Khajavi ◽  
Ehsan Aliasghari ◽  
Moosa Sajjadi
Keyword(s):  
Medication Adherence ◽  
Health System ◽  
Rural Population ◽  
Antihypertensive Medication ◽  
Cross Sectional Study ◽  
Time Interval ◽  
Chi Square ◽  
Related Factors ◽  
Cross Sectional ◽  
Medication Therapy

<p><strong>INTRODUCTION: </strong>Medication therapy is one of the most important interventions for the control of hypertension and its complications, but patient nonadherence to prescribed antihypertensive medication is a challenge. This study was conducted to measure medication adherence and examine its determinants in patients with hypertension in a rural population of Iran.</p><p><strong>METHODS: </strong>This cross-sectional study was conducted on 422 patients with hypertension covered by the healthcare network of Bajestan, Razavi Khorasan Province, Iran. Medication adherence was measured by using the Persian version of the 8 items Morisky Medication Adherence Scale (MMAS-8). The Chi-square test and Spearman’s correlation coefficient were used to examine the relationship between the determinants of medication adherence in SPSS.</p><p><strong>RESULTS: </strong>The mean age of the patients was 65.02±8.88 years. Of the total of 422 patients, 299 (70.9%) were female. Based on the MMAS-8, medication adherence was high in 39.6% of the patients, moderate in 10.9% and low in 49.5%. The variables that correlated significantly with the level of medication adherence included age (P=0.032), education (P=0.022), income (P=0.001), the satisfaction of patients-physician communication (P=0.006), physician based education (P= 0.003), occupation, time interval of physician’s consultation (P=0.001), medication regime complexity (P=0.001), medications meals frequency (P=0.001), side effects (P=0.081) duration of the disease (P=0.015), comorbidities (P=0.001), smoking (P=0.047), patient’s ability to read medication instruction (P=0.011), the patient’s beliefs about the effectiveness of medications (P=0.001) and the patient’s beliefs about the effectiveness of health system (P=0.001). The variables of gender (P=0.147), marital status (P=0.054), and distance problems to the health center (P=0.181) were not significantly correlated with the level of medication adherence.</p><p><strong>CONCLUSION:</strong> The results of the present study revealed a low medication adherence in half of the patients with hypertension due to various personal and socioeconomic determinants as well as factors associated with the health system, therapy-related factors, disease-related factors and patient-related factors. Purposeful interventions therefore appear essential to improving medication adherence in rural populations with a focus on the effect of each determinant of medication adherence.</p>

scholarly journals Adherence To Antihypertensive Medications Among Primary Care Centre Attendees in Trinidad: A Cross-Sectional Study

2021 ◽  
Author(s):  
Shastri Motilal
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Cross Sectional Study ◽  
The Body ◽  
Uncontrolled Hypertension ◽  
Sectional Study ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Assistance Program ◽  
Average Systolic Blood Pressure

Objective: To determine the adherence levels to antihypertensive medications and its associated factors among primary care attendees in Trinidad. Methods: A cross-sectional study was carried out whereby an interviewer-administered questionnaire was administered to public primary care attendees throughout Trinidad. Non-pregnant hypertensive adults, attending chronic disease clinic on anti-hypertensive medications for at least 1 year were eligible. Results: Of 225 participants (92% response rate), 58% displayed a low level of adherence to anti-hypertensive medications and 73.3% had uncontrolled hypertension, both independent of age, gender, and ethnicity. Experiencing adverse effects to prescribed medications (P=0.003) and self-reported use of herbal/alternative treatment (P=0.024) for hypertension were significantly associated with higher rates of low adherence. Having too many pills to take and fear about the potential effects of these medications on the body were both correlated with low adherence (P< 0.001) Obtaining antihypertensive medications from a national chronic disease assistance program was inversely correlated with low adherence (P= 0.03). There were no statistically significant associations between adherence and average systolic blood pressure (P= 0.20), home self-monitoring (P= 0.75), daily dosing frequency (P= 0.53), or daily number of pills (P= 0.68) Conclusion: Most primary care hypertensive patients who attended chronic disease clinics at primary care health centers around Trinidad were found to have uncontrolled hypertension along with low adherence to antihypertensive medications. Education, screening for herbal use, and improvements to the existing national medication program, are discussed as interventions to improve adherence in this setting. Keywords: Hypertension, Adherence, Antihypertensive medications, Primary Care

scholarly journals A cross-sectional study clarifying profiles of patients with diabetes who discontinued pharmacotherapy: reasons and consequences

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoshiko Tominaga ◽  
Donald E. Morisky ◽  
Mayumi Mochizuki
Keyword(s):  
Medication Adherence ◽  
Glycemic Control ◽  
Smoking Habit ◽  
Cross Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Adherence To Medication ◽  
Medication Discontinuation ◽  
Patients With Diabetes ◽  
Cont Group

Abstract Background Although diabetes is one of the fastest increasing diseases in prevalence worldwide and demands significant medical resources, more than half of all patients with diabetes do not achieve the expected target level of blood glucose. As a potential cause of poor glycemic control, insufficient adherence to medication has long been discussed and variably studied. However, dropout from treatment as another plausible cause has not been fully examined. The aim of this study was to clarify profiles of patients with diabetes who discontinued pharmacotherapy (Discont group) by extracting reasons of their decisions and by comparing with those who continued (Cont group) in terms of the related factors to glycemic control. Methods A cross-sectional, internet-based survey was conducted among Japanese with diabetes registered in a database. A self-administered questionnaire consisting of the 8-item version of the Morisky Medication Adherence Scale (MMAS-8), glycosylated haemoglobin (HbA1c) level, and demographic and disease characteristics was completed by all participants. Reasons for medication discontinuation and resumption were also received retrospectively from participants in the Discont group. To examine the risk of uncontrolled HbA1c, logistic regression analysis was conducted in each group. Results In the Discont group (148 cases), older age at resumption of pharmacotherapy and current smoking habit increased the probability of uncontrolled HbA1c, whereas in the Cont group (146 cases), a familial history of diabetes and better medication adherence in MMAS-8 scores decreased the probability of uncontrolled HbA1c. A relationship between medication adherence and HbA1c level was seen in the Cont but not in the Discont group. About 70 % of those in the Discont group made their decision to terminate diabetes treatment without consulting physicians and half of them perceived their situations inappropriately. Conclusions Those who discontinued pharmacotherapy were less adherent to medication than those who did not discontinue. Risk factors for glycemic control also differed between those who discontinued and those who did not. More than one-third of participants with diabetes who discontinued pharmacotherapy had inappropriate perceptions of their disease, which medical professionals should be aware of for better interventions.

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