scholarly journals Clinical impact of guideline-based practice and patients’ adherence in uncontrolled hypertension

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Il Suk Sohn ◽  
Chong Jin Kim ◽  
Byung-Su Yoo ◽  
Byung Jin Kim ◽  
Jae Woong Choi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Treatment Satisfaction ◽  
Pressure Control ◽  
Treatment Patterns ◽  
Uncontrolled Hypertension ◽  
Hypertensive Patients ◽  
Blood Pressure Control Rate ◽  
Patient Reported

Abstract Background Chronic diseases like hypertension need comprehensive lifetime management. This study assessed clinical and patient-reported outcomes and compared them by treatment patterns and adherence at 6 months among uncontrolled hypertensive patients in Korea. Methods This prospective, observational study was conducted at 16 major hospitals where uncontrolled hypertensive patients receiving anti-hypertension medications (systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg) were enrolled during 2015 to 2016 and studied for the following 6 months. A review of medical records was performed to collect data on treatment patterns to determine the presence of guideline-based practice (GBP). GBP was defined as: (1) maximize first medication before adding second or (2) add second medication before reaching maximum dose of first medication. Patient self-administered questionnaires were utilized to examine medication adherence, treatment satisfaction and quality of life (QoL). Results A total of 600 patients were included in the study. Overall, 23% of patients were treated based on GBP at 3 months, and the GBP rate increased to 61.4% at 6 months. At baseline and 6 months, 36.7 and 49.2% of patients, respectively, were medication adherent. The proportion of blood pressure-controlled patients reached 65.5% at 6 months. A higher blood pressure control rate was present in patients who were on GBP and also showed adherence than those on GBP, but not adherent, or non-GBP patients (76.8% vs. 70.9% vs. 54.2%, P < 0.001). The same outcomes were found for treatment satisfaction and QoL (P < 0.05). Conclusions This study demonstrated the importance of physicians’ compliance with GBP and patients’ adherence to hypertensive medications. GBP compliance and medication adherence should be taken into account when setting therapeutic strategies for better outcomes in uncontrolled hypertensive patients.

Abstract P313: Self-reported Sleep Disturbance is Associated With Poor Hypertension Self-management in Latinos

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Billy A Caceres ◽  
Niurka Suero-Tejada ◽  
Leah Estrada ◽  
Suzanne Bakken
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Sleep Disturbance ◽  
Sex Education ◽  
Sleep Disturbances ◽  
Self Management ◽  
Uncontrolled Hypertension ◽  
Measurement Information ◽  
Cross Sectional ◽  
Patient Reported

Background: Antihypertensive medication adherence is an important determinant of hypertension control. Although Latinos have high rates of uncontrolled hypertension, factors associated with anti-hypertensive medication adherence in this population are poorly understood. Self-reported sleep disturbance is associated with impaired chronic disease self-management in the general population. To date, no study has examined the association of sleep disturbance with hypertension self-management among Latinos. Hypothesis: Sleep disturbances will be associated with poor anti-hypertensive medication adherence and higher rates of uncontrolled hypertension in Latinos. Methods: We used cross-sectional data from the Washington Heights/Inwood Comparative Effectiveness Research (WICER) Project to assess the link between sleep disturbance with anti-hypertensive medication adherence and uncontrolled hypertension among Latinos with hypertension. The 8-item Morisky Medication Adherence Scale (MMAS) was used to assess medication adherence (alpha 0.75; range 0-8). The 4-item Patient-Reported Outcomes Measurement Information System (PROMIS) sleep disturbance measure was used (alpha 0.75; range 4-20). Uncontrolled hypertension was defined as a systolic blood pressure ≥130 mm Hg and/or diastolic blood pressure ≥80 mm Hg. Multiple logistic regression models were used to examine the associations of self-reported sleep disturbance with low medication adherence (MMAS <6). In addition, we examined whether sleep disturbance was associated with uncontrolled hypertension. Models were adjusted for age, sex, education, preferred language, insurance status, comorbid conditions, and anxiety. Results: The final sample consisted of 1,116 Latino participants with hypertension (mean age 63.2, 76.8% were female, and 69.5% had completed less than a high school education). The mean MMAS and PROMIS sleep disturbance scores were 1.9 and 10.1, respectively. A total of 341 (30.4%) participants were classified as having low medication adherence. Participants with low medication adherence were more likely to be younger (p <0.001), single (p <0.001), and have lower educational attainment (p <0.01). After covariate adjustment, a one-point increase in sleep disturbance was associated with higher odds of low medication adherence (AOR 1.05, 95% CI [1.01-1.09]). Sleep disturbance was also associated with higher odds of uncontrolled hypertension (AOR 1.04, 95% CI [1.01-1.07]). Conclusions: Reducing sleep disturbance in Latinos may be an important target for improving hypertension self-management. It remains unclear whether sleep disturbances are a cause of poor hypertension self-management in these patients. Additional research that incorporates longitudinal designs is needed to examine associations between sleep disturbance and hypertension self-management among Latinos.

scholarly journals Medication Adherence and Blood Pressure Control Among Hypertensive Patients With Coexisting Long-Term Conditions in Primary Care Settings

Medicine ◽  
2016 ◽  
Vol 95 (20) ◽  
pp. e3572 ◽  
Author(s):  
Yu Ting Li ◽  
Harry H.X. Wang ◽  
Kirin Q.L. Liu ◽  
Gabrielle K.Y. Lee ◽  
Wai Man Chan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Medication Adherence ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Long Term Conditions ◽  
Hypertensive Patients ◽  
Primary Care Settings
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