Adherence to Antihypertensive Therapy

Peacock, Erle E.; Krousel‐Wood, Marie

doi:10.1016/j.mcna.2016.08.005

Cited by 105 publications

(93 citation statements)

References 82 publications

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“…It is important to understand potentially modifiable factors that physicians and/or healthcare system can attempt to overcome medication non‐adherence . The results of this meta‐analysis confirm that promising strategies to improve medication adherence include regimen simplification and reduction of out‐of‐pocket costs . Improving adherence requires a continuous, individualised and dynamic process .…”

Section: Discussionmentioning

confidence: 69%

“…Physicians contribute to patients' non‐adherence, among other factors, by prescribing complex regimens. Therefore, the prescription must be individualised, simplified and limited to the lowest number of daily doses …”

Section: Discussionmentioning

confidence: 99%

“…A Brazilian study showed that the regularity of free access to specific medications affects patient behaviour and contributes to their commitment to treatment and self‐care . A number of other studies and a meta‐analysis have demonstrated that low adherence to medications is associated with depression and stressful life events . The understanding of different mechanisms underlying adherence behaviour may enhance patient‐specific approaches to improve adherence …”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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“…Evidence shows that BP control could be improved by better treatment compliance, but, in clinical practice, improving medication adherence remains a challenge . Pill burden was significantly associated with decreased adherence to antihypertensive therapies in real‐practice settings .…”

Section: Discussionmentioning

confidence: 99%

“…Globally, hypertension affected 31.1% of the global population, or 1.4 billion people, worldwide in 2010 and resulted in 9.4 million deaths annually . The control of high blood pressure (BP) by antihypertensive drugs is crucial for patients with hypertension, by reducing the risk of stroke and renal and cardiovascular disease . A standardized reduction of 10/5 mm Hg systolic BP/diastolic BP reduces the of stroke by 36%, heart failure by 43%, coronary events by 16%, cardiovascular death by 18%, and all‐cause mortality by 11% .…”

Section: Introductionmentioning

confidence: 99%

The impact of fixed‐dose combination versus free‐equivalent combination therapies on adherence for hypertension: a meta‐analysis

Cheng

Zhang

et al. 2018

J of Clinical Hypertension

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Nonadherence to antihypertensive medication is considered as a reason of inadequate control of blood pressure. This meta-analysis aimed to systemically evaluate the impact of fixed-dose combination (FDC) therapy on hypertensive medication adherence compared with free-equivalent combination therapies. Articles were retrieved from MEDLINE and Embase databases using a combination of terms "fixed-dose combinations" and "adherence or compliance or persistence" and "hypertension or antihypertensive" from January 2000 to June 2017 without any language restriction. A meta-analysis was performed to parallel compare the impact of FDC vs free-equivalent combination on medicine adherence or persistence. Studies were independently reviewed by two investigators. Data from eligible studies were extracted and a meta-analysis was performed using R version 3.1.0 software. A total of nine studies scored as six of nine to eight of nine for Newcastle-Ottawa rating with 62 481 patients with hypertension were finally included for analysis. Results showed that the mean difference of medication adherence for FDC vs free-equivalent combination therapies was 14.92% (95% confidence interval, 7.38%-22.46%). Patients in FDC group were more likely to persist with their antihypertensive treatment, with a risk ratio of 1.84 (95% confidence interval, 1.00-3.39). This meta-analysis confirmed that FDC therapy, compared with free-equivalent combinations, was associated with better medication adherence or persistence for patients with hypertension. It can be reasonable for physicians, pharmacists, and policy makers to facilitate the use of FDCs for patients who need to take two or more antihypertensive drugs.

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Analysis of antiplatelet therapy adherence in patients with ischemic cerebral stroke

et al. 2023

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Background:The related factors affecting the adherence of ischemic cerebral stroke (ICS) patients to antiplatelet therapy have attracted much attention.Methods: Patients with ICS (confirmed by CT or MRI) were enrolled from January 2020 to July 2021. The demographic data were retrospectively investigated and analyzed. The adherence calculation was as follows: Adherence = number of tablets taken/number of tablets needed to be taken. Adherence < 100% was defined as nonadherence. Severe nonadherence is defined as adherence ≤ 75%.Results: A total of 229 patients with ICS were enrolled. We found no significant difference in the proportion of patients with nonadherence, while the proportion of severe nonadherence in the aspirin group was significantly higher (p < .001). Multivariable analysis indicated that medical insurance (odds ratio [OR] = 0.071, p < .001) and regular exercise (OR = 0.438, p = .015) were independent factors associated with adherence. In addition, only medical insurance (OR = 5.475, p < .001) and aspirin treatment (OR = 0.228, p < .001) were independent risk factors associated with severe nonadherence. We therefore constructed a nomogram plot and a model as follows:Adherence risk score = 3 × medical insurance + regular exercise. Patients were divided into low-risk and high-risk groups for adherence based on the median model score.A total of 13.3% of patients in the low-risk group were nonadherent patients compared with 53.4% in the high-risk group (p < .001). Similarly, 8.4% of patients in the low-risk group had severe nonadherence compared with 19.9% in the high-risk group (p = .022). Moreover, in low-risk patients, no significant difference was observed.In patients with high risk, aspirin-treated patients showed significantly decreased adherence compared with the other two groups. Conclusion:Medical insurance and regular exercise were independent factors for antiplatelet therapy adherence. For patients with high model scores, timely intervention is necessary.Jie Zhong and Yuguang Gao contributed equally to this work.

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Adherence to Antihypertensive Therapy

Cited by 105 publications

References 82 publications

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

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

The impact of fixed‐dose combination versus free‐equivalent combination therapies on adherence for hypertension: a meta‐analysis

Analysis of antiplatelet therapy adherence in patients with ischemic cerebral stroke

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