Patients' decisions about whether or not to take antihypertensive drugs: qualitative study

Benson, John; Britten, Nicky

doi:10.1136/bmj.325.7369.873

Cited by 183 publications

(160 citation statements)

References 11 publications

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“…Mikið getur unnist fyrir ár-angur meðferðar með því að baeta slík tengsl. 3,10,11 Samskipti laekna og lyfjafyrirtaekja geta einnig haft áhrif á viðhorfin. Sjúklingar líta svo á að gjafir til laekna frá lyfjafyrirtaekjum séu algengar og þetta veldur þeim áhyggjum.…”

Section: Inngangurunclassified

Icelanders' beliefs about medicines. Use of BMQ

Vilhelmsdóttir¹,

Jóhannsson²

2017

LBL

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Objective: To study beliefs held by the general public in Iceland about medicines. Methods: The Beliefs about Medicines Questionnaire was used to explore Icelanders' beliefs about medicines. A sample of 1500 Icelandic citizens, aged 18-75, obtained from the Social Science Research Institute was given The Beliefs about Medicines Questionnaire. Results: The response rate was 61.6%. Most Icelanders have positive beliefs about their medication as well as general trust. Those who suffer from chronic diseases are more positive towards medicines than others and less inclined to view them as excessively used and harmful. Higher level of education predicts more positive beliefs towards medication - and vice versa. Gender and age do not seem to affect such beliefs. Conclusion: Gaining a better understanding of people´s beliefs about medicines and what determines these beliefs can be of considerable value in the search for ways to improve therapy and adherence, especially for those suffering from chronic diseases. Promoting education for the general public about medicines might result in less misunderstanding among patients and subsequently better grounded beliefs and more adequate therapeutic adherence.

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Section: Inngangurunclassified

Icelanders' beliefs about medicines. Use of BMQ

Vilhelmsdóttir¹,

Jóhannsson²

2017

LBL

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“…For instance, previous studies have shown a positive association between medication adherence and the physician-patient relationship. 24 Owing to constraints in the length of the survey our study did not investigate this aspect.…”

Section: Limitationsmentioning

confidence: 99%

Patient satisfaction with antihypertensive therapy

et al. 2005

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The objective of the study was to assess factors associated with treatment satisfaction among patients receiving antihypertensive therapy. A weighted crosssectional online survey was conducted with hypertensive patients participating in a chronic disease panel in the US. Patients on monotherapy with medications from the following classes were identified: ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), beta blockers (BBs), calcium channel blockers (CCBs), and diuretics. The control group included patients without treatment. Pairwise comparisons between groups were conducted for factors that may affect patients' satisfaction. The study population had a mean age of 54.7714.2 years and was 56.7% female. Participants with blood pressure (BP) controlled to JNC 7 guidelines were more satisfied with their medication than those with uncontrolled BP (90.3 vs 71.5%, Po0.05). Patients who had not experienced adverse events had higher satisfaction than patients experiencing adverse events (90.9 vs 75.8%, Po0.05). The most frequently self-reported adverse events were frequent urination, sexual dysfunction, and fatigue ranging from 7.0 to 9.6% across classes. The adverse event rates differed by class and were lowest among the ARBs. Patients on ARBs were the most likely to have switched from a previous antihypertensive class as compared to other classes (57.1% ARBs vs 49.8% ACEIs, 38.7% diuretics, 36.3% CCBs, and 31.7% BBs). Physician recommendation was the most common reason for switching. In conclusion, the ability to effectively treat hypertension depends upon a patient's satisfaction with antihypertensive therapy, which may be improved by achieving BP control and minimizing the occurrence of adverse events.

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“…8 In addition, many patients experience unpleasant side effects from their medication that may be unacceptable in a largely asymptomatic disease. This is often reported as one of the main reasons for non-or partial compliance.9-11 However, more recent studies have focused on patient's decisions and the complex relationship between the patient and physician as possible mediating factors for compliance.Patients often make rational decisions about the benefits of medication compared to the risks before they decide whether or not to comply with treatment.10 Several studies, 9-12 some qualitative, 9,11 have investigated how hypertensive patients balance these concerns with their reasons for taking such medication. The majority of patients (80%) also express general concerns about taking medication; previous bad experiences, perceptions that drugs are unnatural or unsafe and are best avoided, and that drugs signify ill health.…”

mentioning

confidence: 99%

“…The majority of patients (80%) also express general concerns about taking medication; previous bad experiences, perceptions that drugs are unnatural or unsafe and are best avoided, and that drugs signify ill health. 9 With regard to …”

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confidence: 99%

Compliance with pharmacological therapy in hypertension: can we do better, and how?

2004

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Noncompliance with treatment has long been the plague of the national health-care system. Each year it is estimated that noncompliance with medication costs the UK economy billions of pounds, as a result of preventable hospital admissions and loss of productivity due to illness. In addition, noncompliance has been identified as the predominant reason for the failure of medical therapy and disease progression. Compliance has been defined as 'the extent to which a person's behaviour coincides with medical care or advice'.1 In the management of hypertension, figures from the United States suggest that noncompliance with medication may be as high as 50-80%, with compliance decreasing rapidly over time. 2,3 Based on the current definition of hypertension (blood pressure (BP) of X140/90 mm Hg), 4 the 1998 Health Survey for England revealed that 42% and 33% of adult (X16 years) men and women, respectively, were hypertensive.5 Fewer than 10% of all UK hypertensive patients currently achieve the recommended target BP of o140/90 mmHg, 6,7 despite the well-known risks associated with hypertension and the overwhelming evidence from numerous clinical trials of the benefits of antihypertensive medication. A recent study, based on a meta-analysis of 61 prospective BP studies, calculated that if all hypertensive patients in the UK reduced their systolic BP to o140 mmHg, approximately 21 400 stroke deaths, 41 400 ischaemic heart disease (IHD) deaths, and 125 600 events (nonfatal stroke or IHD) could be prevented each year.7 Why then, in the face of such overwhelming evidence of the benefits of BP reduction, are less than one in 10 people in the UK achieving adequate control of their BP?Various explanations have been proffered to explain why such a large percentage of patients have resistant hypertension, including secondary hypertension and endogenous resistance to treatment. However, the main reason for inadequate control of BP is poor compliance with the treatment regimen, both pharmacological and behavioural (eg, weight reduction, sodium intake restriction, and exercise). Understanding the reasons for patient noncompliance with antihypertensive medication is essential if BP is to be more effectively managed. Table 1 presents some possible factors contributing to noncompliance with medication regimens.Much of the earlier research focused on identifying patient characteristics of noncomplaint individuals and the complexity of the medication regimen. BP control typically requires more than one antihypertensive medication and the frequency of dosing may vary. The complexity of the drug regimen effects compliance; compliance among hypertensive patients improves considerably when drugs are prescribed just once a day. 8 In addition, many patients experience unpleasant side effects from their medication that may be unacceptable in a largely asymptomatic disease. This is often reported as one of the main reasons for non-or partial compliance.9-11 However, more recent studies have focused on patient's decisions and the complex relation...

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Patients' decisions about whether or not to take antihypertensive drugs: qualitative study

Abstract: Objective To describe the ways in which patients taking antihypertensive drugs balance reservations against reasons for taking them.

Cited by 183 publications

References 11 publications

Icelanders' beliefs about medicines. Use of BMQ

Icelanders' beliefs about medicines. Use of BMQ

Patient satisfaction with antihypertensive therapy

Compliance with pharmacological therapy in hypertension: can we do better, and how?

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