Adherence to antihypertensive treatment: a critical factor for blood pressure control

Abstract

Compliance is associated with more effective BP control. Physicians can enhance patient compliance and hypertension control by devoting more time to counselling, avoiding unnecessary changes in drug regimens and restricting the tablet numbers.

Factors Associated with Adherence to Anti-Hypertensive Treatment in Pakistan

“…This finding is consistent with a number of other studies [30], [31], [32] including the regional study in Malaysia [16], although there are studies which show either no association [4], [23] or decreasing adherence with increasing age [33]. Increasing self-reliance in old age has been shown to decrease adherence [34]. In the Pakistani population, a better social support structure ensured by the common extended family system, reduces self-reliance and could be the reason for better adherence in this age group.…”

Cardiovascular medication utilization and adherence among adults living in rural and urban areas: a systematic review and meta-analysis

“…Six (12%) studies [29,37,46,70,73,74] evaluated cardiovascular medication adherence and two (4%) studies [46,50] evaluated medication persistence. Adherence was measured as the percentage of doses taken [73], the proportion of patients with a medication possession ratio ≥0.8 [46], and was undefined in three studies [37,70,74].…”

“…Adherence was measured as the percentage of doses taken [73], the proportion of patients with a medication possession ratio ≥0.8 [46], and was undefined in three studies [37,70,74]. Persistence was measured as the proportion of patients remaining on the same [46,50] or any treatment [46] at the end of the follow up.…”

“…The odds of treatment persistence were significantly higher in rural versus urban patients in one report (adjusted OR 1.28, 95% CI 1.25, 1.32) [46], but was not statistically different in a second study (OR 0.96, 95% CI 0.55, 1.67) [50], Medication adherence data from three studies (4 cohorts) were pooled and showed no statistically significant difference between rural and urban patients (unadjusted OR 0.94, 95% CI 0.39, 2.27, p = 0.89, I 2  = 91%) Table 1[29,37,70]. In two other reports with data not suitable for meta-analysis, medication adherence was significantly higher in one study (92% versus 83% of doses taken, p = 0.01) [73], and significantly lower in the other (10% versus 17% of patients compliant, p < 0.01) [74], for rural versus urban patients, based on unadjusted data. The three studies reporting treatment adherence adjusted for confounders reported adherence to be significantly higher in rural patients (OR medication possession ratio ≥0.8: antihypertensive agents 1.2, 95% CI 1.1, 1.3; ASA 1.14, 95% CI 1.10, 1.18; ACEI/ARB 1.18 95% CI 1.14, 1.23) or rural men (OR adherent 4.0, 95% CI 1.1, 13.9) [29,46,70].…”

Hipertensión arterial en adultos mexicanos: prevalencia, diagnóstico y tipo de tratamiento. Ensanut MC 2016

“…Esta prevalencia es considerablemente más baja que la de países como Cuba (85.8%), Estados Unidos (65.4%) y Chile (56.8%), 23 donde los sistemas de salud utilizan a médicos especialistas en el manejo de la hipertensión arterial y en mejorar la adherencia al tratamiento de enfermedades crónicas. [39][40][41] El uso de tratamiento farmacológico contribuye sólo un poco al descenso de la tensión arterial cuando la totalidad de factores de riesgo asociados no son modificados. 42 En la Ensanut MC 2016 el porcentaje de adultos con tratamiento farmacológico fue relativamente alto (79.3%); sin embargo, solamente la mitad de ellos tenía una tensión arterial controlada, menos de 20% practicaba modificaciones en su estilo de vida y 12.7% medía su tensión arterial al menos una vez a la semana.…”