How to avoid discontinuation of antihypertensive treatment. The experience in São Paulo, Brazil

Ortega, Kátia Coelho; Gusmão, Josiane Lima de; Pierin, Ângela Maria Geraldo; Nishiura, José Luiz; Ignez, Edna Caetano; Segre, Carlos Alexandre Wainrober; Ventura, Carlucci Gualberto; Mano, Gisele Peixoto; Fontes, Viviane; Cunha, Francisco Mogadouro da; Mion, Décio

doi:10.1590/s1807-59322010000900008

Cited by 9 publications

(13 citation statements)

References 27 publications

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“…(26,28) The management of hypertension through the use of simple, effective, accessible and continuing strategies, such as health information technology, permit approximation, orientation of clients and family members and monitoring of pressure levels through telephone calls and frequent messages. (29) The residential monitoring of blood pressure should also be stimulated. (28) The combination of these actions offers tools for the individuals to consider themselves as agents responsible for self-care.…”

Section: Discussionmentioning

confidence: 99%

Fatores associados ao descontrole da pressão arterial em homens

et al. 2016

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Conflicts of interest: no conflicts of interest to declare. ResumoObjetivo: Verificar os fatores associados ao descontrole da pressão arterial em homens. Métodos: Estudo exploratório, de corte transversal, realizado em centro de referência para doenças cardiovasculares, em Salvador-BA, lócus para o núcleo de referência do programa de saúde do homem do Ministério da Saúde. Amostra foi selecionada por conveniência totalizando 130 homens atendidos em centro de saúde, submetidos a entrevista, avaliação clínica e antropométrica. Na análise bivariada empregou-se o Qui-quadrado de Pearson ou Exato de Fisher realizando-se posteriormente análise de regressão logística múltipla sendo a OR corrigida pelo modelo de Poisson. Adotou-se significância estatística de 5%. Resultados: Constatou-se alta prevalência de descontrole da pressão arterial (65,4%), de hábitos de vida inadequados e de excesso de peso. Não houve associação estatisticamente significante entre descontrole dos níveis pressóricos e variáveis sociodemográficas, hábitos de vida e medidas antropométricas. Na regressão, o descontrole da pressão arterial associou-se ao uso inadequado da medicação (RP: 1,35, IC 95%: 1,03; 1,76). Conclusão: O uso inadequado da medicação foi reforçado como importante fator associado ao descontrole. Medidas efetivas para mudança deste panorama são emergenciais e desafiam profissionais e autoridades públicas. ResumoObjective: Verify the factors associated with lack of blood pressure control in men. Methods: Exploratory and cross-sectional study undertaken at a referral center for cardiovascular diseases in Salvador-BA, where the referral center of the Ministry of Health's male health program is located. A convenience sample was selected, totaling 130 men attended at a health center, submitted to interview, clinical and anthropometric assessment. In the bivariate analysis, Pearson's Chi-squared or Fisher's Exact test was employed, followed by multiple logistic regression analysis. The OR was corrected by means of Poisson's model. Statistical significance was set at 5%. Results: The high prevalence of lack of blood pressure control (65.4%), inappropriate living habits and overweight was verified. No statistically significant association was found between lack of pressure control and sociodemographic variables, living habits and anthropometric measures. In the regression, the lack of blood pressure control was associated with inappropriate medication use (PR: 1.35, 95% CI: 1.03; 1.76). Conclusion: Inappropriate medication use was emphasized as an important factor associated with lack of control. Effective measures to change this situation are urgent and challenge professionals and public authorities.

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Section: Discussionmentioning

confidence: 99%

Fatores associados ao descontrole da pressão arterial em homens

et al. 2016

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“…The ease of access to the target population via telephone is also important given the mobile phone system and technological advances in the field. A clinical trial conducted in Brazil compared two groups of patients with hypertension and showed that those who received telephone calls had lower treatment dropout rates (p<0.05) (14) .…”

Section: Discussionmentioning

confidence: 99%

“…With regard to the latter, the inclusion of healthcare team members such as the nurse tends to favor treatment adherence (13) . Importantly, telephone contact also positively affects chronic disease treatment adherence (14) .…”

Section: Introductionmentioning

confidence: 99%

Adherence to anti-hypertensive treatment within a chronic disease management  program: A longitudinal, retrospective study

Raymundo

Pierin

2014

Rev. esc. enferm. USP

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Objective This study assessed pharmacological treatment adherence using the Morisky-Green Test and identified related variables. Method A longitudinal and retrospective study examined 283 patients with hypertension (62.5% women, 73.4 [10.9] years old) who were being monitored by a chronic disease management program for 17 months between 2011 and 2012. Nurses performed all the actions of the program, which consisted of advice via telephone and periodic home visits based on the risk stratification of the patients. Results A significant increase in treatment adherence (25.1% vs. 85.5%) and a decrease in blood pressure were observed (p<0.05). Patients with hypertension and chronic renal failure as well as those treated using angiotensin-converting enzyme inhibitors were the most adherent (p<0.05). Patients with hypertension who received angiotensin receptor blockers were less adherent (p<0.05). Conclusions Strategies such as nurse-performed chronic disease management can increase adherence to anti-hypertensive treatment and therefore contribute to the control of blood pressure, minimizing the morbidity profiles of patients with hypertension.

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“…Randomization was performed by means of drawing from envelopes, and the patients were followed for a period of 12 months (9). …”

Section: Methodsmentioning

confidence: 99%

An economic evaluation of antihypertensive therapies based on clinical trials

Tsuji¹,

Silva²,

Ortega³

et al. 2012

Clinics

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OBJECTIVE:Hypertension is a major issue in public health, and the financial costs associated with hypertension continue to increase. Cost-effectiveness studies focusing on antihypertensive drug combinations, however, have been scarce. The cost-effectiveness ratios of the traditional treatment (hydrochlorothiazide and atenolol) and the current treatment (losartan and amlodipine) were evaluated in patients with grade 1 or 2 hypertension (HT1-2). For patients with grade 3 hypertension (HT3), a third drug was added to the treatment combinations: enalapril was added to the traditional treatment, and hydrochlorothiazide was added to the current treatment.METHODS:Hypertension treatment costs were estimated on the basis of the purchase prices of the antihypertensive medications, and effectiveness was measured as the reduction in systolic blood pressure and diastolic blood pressure (in mm Hg) at the end of a 12-month study period.RESULTS:When the purchase price of the brand-name medication was used to calculate the cost, the traditional treatment presented a lower cost-effectiveness ratio [US$/mm Hg] than the current treatment in the HT1-2 group. In the HT3 group, however, there was no difference in cost-effectiveness ratio between the traditional treatment and the current treatment. The cost-effectiveness ratio differences between the treatment regimens maintained the same pattern when the purchase price of the lower-cost medication was used.CONCLUSIONS:We conclude that the traditional treatment is more cost-effective (US$/mm Hg) than the current treatment in the HT1-2 group. There was no difference in cost-effectiveness between the traditional treatment and the current treatment for the HT3 group.

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How to avoid discontinuation of antihypertensive treatment. The experience in São Paulo, Brazil

Cited by 9 publications

References 27 publications

Fatores associados ao descontrole da pressão arterial em homens

Fatores associados ao descontrole da pressão arterial em homens

Adherence to anti-hypertensive treatment within a chronic disease management  program: A longitudinal, retrospective study

An economic evaluation of antihypertensive therapies based on clinical trials

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How to avoid discontinuation of antihypertensive treatment. The experience in São Paulo, Brazil

Cited by 9 publications

References 27 publications

Fatores associados ao descontrole da pressão arterial em homens

Fatores associados ao descontrole da pressão arterial em homens

Adherence to anti-hypertensive treatment within a chronic disease management program: A longitudinal, retrospective study

An economic evaluation of antihypertensive therapies based on clinical trials

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Product

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Adherence to anti-hypertensive treatment within a chronic disease management  program: A longitudinal, retrospective study