Low medication adherence is associated with decline in health-related quality of life: results of a longitudinal analysis among older women and men with hypertension

Abstract

Objective: The aim of this study was to determine the association of low antihypertensive medication adherence with decline in health-related quality of life (HRQOL) over 1 year. Methods: We used data from older men and women with hypertension ( n = 1525) enrolled in the Cohort Study of Medication Adherence among Older Adults. Adherence was measured using the validated self-report four-item Krousel-Wood Medication Adherence Scale (K-Wood-MAS-4) (low adherence = score ≥1) and prescription refill-based proportion of days covered (PDC) (low adherence = PDC < 0.80). We defined decline in HRQOL as a decrease in Mental Component Summary (MCS) or Physical Component Summary (PCS) score (from the RAND 36-Item Health Survey 1.0 administered at two time points – at the time of adherence assessment and 1 year later) equivalent to the minimal important difference (MID) for each respective summary score, calculated as the average of MID estimates derived from distribution and anchor-based approaches. Results: The prevalence of low adherence was 38.6% using the K-Wood-MAS-4 and 23.9% using PDC. On the basis of mean MID estimates of 4.40 for MCS and 5.16 for PCS, 21.8 and 25.2% of participants experienced a decline in MCS and PCS, respectively, over 1 year. Low adherence was associated with a decline in MCS for K-Wood-MAS-4 [prevalence ratio = 1.32, 95% confidence interval (95% CI) 1.08–1.62, P = 0.008], but not PDC (prevalence ratio = 1.17, 95% CI 0.94–1.47, P = 0.168). Low adherence was not associated with decline in PCS (K-Wood-MAS-4: prevalence ratio = 0.95, 95% CI 0.79–1.16; PDC: prevalence ratio = 1.10, 95% CI 0.90–1.35). Conclusion: Low self-report medication adherence is associated with decline in mental HRQOL over 1 year in older adults with hypertension.

Feel to Heal: Negative Emotion Differentiation Promotes Medication Adherence in Multiple Sclerosis

“…Critically, our sample comprised patients who were recently diagnosed with MS, a period of elevated stress for most new patients, and suggests that NED affords protection even in such highly aversive contexts. This appears especially important given that treatment compliance reduces symptom exacerbations in MS, and in so doing, may help to improve patients’ health in addition to psychological well-being and quality of life ( Khayyat et al, 2019 ; Peacock et al, 2021 ). Finally, these results replicate prior findings associating NED with treatment compliance in patients with a congenital blood disorder ( Coifman et al, 2014 ) and reinforce the importance of considering affective processes in chronic disease management.…”

Pengaruh Kepatuhan Minum Obat Antihipertensi terhadap Kualitas Hidup Pasien di Puskesmas Beji Batu

“…Berdasarkan penelitian sebelumnya menunjukkan bahwa kepatuhan minum obat yang rendah dikaitkan dengan penurunan kualitas hidup pasien dengan hipertensi (Peacock et al, 2021). Kualitas hidup pasien diharapkan akan lebih baik ketika pengobatan dijalani secara teratur.…”

“…Berdasarkan hasil analisis regresi ordinal menunjukkan bahwa p value sebesar 0,00 atau <0,05, dapat diinterpretasikan bahwa terdapat pengaruh kepatuhan minum obat terhadap kualitas hidup pasien. Kepatuhan minum obat antihipertensi yang rendah dikaitkan dengan penurunan kualitas hidup pasien lanjut usia dengan HT terutama aspek mental selama 1 tahun (Peacock et al, 2021). Nilai R square, Nagelkerke memiliki nilai sebesar 0,884 dapat dimaknai bahwa kepatuhan minum obat antihipertensi mempengaruhi kualitas hidup pasien sebesar 88,4%.…”

The role of illness perceptions on medication nonadherence among patients with hypertension: A multicenter study in indonesia

“…Patients may experience different types of nonadherence to antihypertensive medications, that is intentional (a conscious and active decision after balancing the pros and cons of a medication) and unintentional (passive decision due to factors beyond the patient’s control) non-adherence ( Lowry et al, 2005 ; Bae et al, 2016 ). The nonadherence to antihypertensive medications is associated with increased risks of resistant hypertension ( Hamrahian, 2020 ), cerebrovascular and coronary events ( Corrao et al, 2011 ), reduced quality of life ( Peacock et al, 2021 ), and increased healthcare costs ( Mennini et al, 2015 ). Therefore, recent guidelines have highlighted the urgency to address medication nonadherence as a major problem in the management of hypertension ( Unger et al, 2020 ).…”