Adherence of patients to long-term medication: a cross-sectional study of antihypertensive regimens in Austria

Abstract

The objective of this study was to evaluate adherence and causes for non-adherence to antihypertensive therapy in Austrian patients. A special focus was laid on social parameters and behavioural theories. Methods:Patients were invited via advertisements in community pharmacies in Austria to complete an online survey. Inclusion criteria were an age of 18 years or older, a diagnosis of arterial hypertension and a current prescription of antihypertensive medication. Adherence was measured by the 4-item Morisky scale. Non-adherence was defined by at least one point in the Morisky scale. Several demographic, social and behavioural parameters were analysed as potential co-variables associated with adherence. Results:323 patients completed the online survey of which 109 (33.7%) met the criteria for nonadherence. In a multivariable model self-efficacy and age were associated with adherence, whereas intention and barriers were linked to non-adherence. 56 patients (17.3%) were classified as intentionally non-adherent. Conclusion:This study demonstrates that non-adherence affects an important proportion of patients in the treatment of arterial hypertension. Young age was a particularly important risk factor for non-adherence and this patient population is therefore in need of special attention. Modifiable risk factors were identified which could help improving the treatment of arterial hypertension and potentially other chronic conditions.

Effect of characteristics of pharmacotherapy on non-adherence in chronic cardiovascular disease: A systematic review and meta-analysis of observational studies

“…The median sample size for all surveyed studies was 885 participants (range 109‐7425), with a total of 27 441 participants included in this review. Eleven studies were based in North America, 7 in Asia, 5 in South America, 4 in Europe, 2 in Africa, and 3 were conducted in multiple countries . The most common condition studied was Hypertension (n = 27).…”

“…The studies reported the outcomes in 4 ways: overall non‐adherence to medication (n = 10), non‐adherence to individual classes of medications (n = 11), overall adherence to medication (n = 8) and adherence to individual classes of medications (n = 2) . Prevalence of overall non‐adherence to medication ranged from 8.2 to 74.9%; whereas non‐adherence to individual classes of medication ranged from 4.0 to 75.8%; overall adherence to medication ranged from 21.2 to 78%; and adherence to individual classes of medication ranged from 15.0 to 77.4%.…”

“…Twelve articles used the MMAS‐4 as the instrument to measure adherence to medicines, 8 articles used the MMAS‐8, 8 articles used an instrument elaborated by the author and 3 used other instruments in their evaluations . Although most of the studies (n = 23) used validated instruments, cut‐off scores and mechanisms to score, the answers “yes” and “no” varied among studies.…”

“…Although most of the studies (n = 23) used validated instruments, cut‐off scores and mechanisms to score, the answers “yes” and “no” varied among studies. Among the studies that used the MMAS‐4: 7 categorised as non‐adherence if score ≥1 (1 point for each “yes”); 2 studies categorised as non‐adherence if score <3 (1 point for each “no”); and 2 studies considered non‐adherence if score ≤3 (1 point for each “no”) . Among studies that used the MMAS‐8: 6 considered low adherence if score <6 (1 point for each “no”); and 2 studies considered low adherence if score ≤6 (1 point for each “no”) .…”

The Structure of Pharmacotherapy of Arterial Hypertension and Adherence in Young Patients

“…возрастным. Молодые пациенты с артериальной гипертензией в этом отношении наименее обследованы, хотя в последние годы получены данные зарубежных ученых [10,11]. Следует указать, однако, на то, что в условиях различных экономических систем, систем здравоохранения вклад факторов, влияющих на приверженность терапии, существенно различается [12].…”