Is the Association between Herbal Use and Blood-Pressure Control Mediated by Medication Adherence? A Cross-Sectional Study in Primary Care

Abstract

Herbs have been used worldwide for many health conditions as an alternative treatment, including hypertension. Their use might affect the use of conventional medications, as well as blood-pressure control. This study aims to determine whether the potential associations between herb use and high blood pressure in hypertensive patients was mediated by medication adherence. A cross-sectional study was conducted using questionnaires and available medical databases at a primary care clinic of a tertiary hospital in Chiang Mai, Thailand. The data were collected from 450 patients with essential hypertension. Drug adherence was assessed by the Morisky Green Levine Medication Adherence Scale. The history of herbs used in the past three months was obtained. The goal of controlled blood pressure was defined in accordance with the Thai guidelines on the treatment of hypertension. Of the total 450 patients, 42% had high adherence. Nearly 18% reported herb use in the past three months. High medication adherence was strongly associated with blood-pressure control when adjusted for age, gender, education, the presence of comorbidities, and herb use (aOR 26.73; 95% CI 8.58–83.23; p < 0.001). The association between herb use and blood-pressure control did not achieve statistical significance (p = 0.143). However, the adjusted odds ratio of the association between herb use and blood-pressure control was diluted from 0.67 to 0.83 when adding the factor of medication adherence to the model. In conclusion, herb use was associated with poor medication adherence, which was in turn associated with poor blood-pressure control. Assessing this information contributes to appropriate exploration and counseling.

Herbal medicine use in Thai patients with type 2 diabetes mellitus and its association with glycemic control: A cross-sectional evaluation

“…Although research on the pharmacology of the phytochemical constituents of herbal plants and the prevalence of herbal medicine use among patients with chronic diseases, including diabetes, has been extensively undertaken in Thailand [ 10 , 20 , 21 , 22 ], studies on herbal medicine used in combination with prescribed antidiabetic agents for T2DM management in Thai patients in primary care units are rarely documented. Therefore, this study aimed to ascertain the prevalence of herbal medicine used in combination with antidiabetic agents and its association with glycemic control (reflected by HbA1c levels) in patients with T2DM at the primary care clinics of four district hospitals across Thailand.…”

Medication Adherence in Chronic Older Patients: An Italian Observational Study Using Medication Adherence Report Scale (MARS-5I)

“…Our findings show that the sample was always adherent in 71.43%; often adherent in 9.79%; sometimes adherent in 14.89%; rarely adherent in 3.87%; and never adherent in 1%, reporting a high MARS-5I mean score of 22.43. Previous studies in other countries have also reported a high medication adherence, although different tools to assess medication adherence have been used [15,30].…”

“…Healthcare professionals must implement a proper communication process, especially in care transition when the therapeutic plan is communicated to the patient. Patients and physicians should cooperate to ease any problems, to enhance medication adherence resulting from other factors [30]. Moreover, it was demonstrated that, after discharge from hospital, the home setting can be a suitable venue for medication review and education.…”

“…Several studies have also shown that telehealth and E-health interventions could represent further elements in the management of drug therapy and in the implementation of adequate medication adherence in patients with chronic diseases [43,44]. Among other strategies regarding the improvement of medication adherence, health communication intervention proved to be a key interactive element tailored to patients [30,45,46].…”

Effect of Social Support and Self Efficacy on Drug Taking Adherence in Hypertensive Patients: A Meta-Analysis

“…Hypertension is a disease that included in health problems and occurs globally. Hypertension has the potential to cause chest pain, heart attack, stroke, and even sudden death, so routine blood pressure checks are very important to do as an effort to prevent hypertension and the diseases that arise as a result (Thangsuk et al, 2021).…”