Post-discharge evaluation of medication adherence and knowledge of hypertension among hypertensive stroke patients in northwestern China

Pan, Jingjing; Tao, Lei; Hu, Bin; Li, Qiongge

doi:10.2147/ppa.s147605

Cited by 33 publications

(52 citation statements)

References 52 publications

(53 reference statements)

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“…Previous studies showed that adherence for medications in chronic diseases averages only 50% whereas in our study it was 41%. 9 The medication adherence rate for antihypertensive in our study was 45% comparable to other studies from USA (51.3%), Germany (56.3%), UK (58.4%) and China (35.23%) 18 . Adher-ence to anti-diabetic drugs was 70% in our study which was higher than previous studies done in Mumbai, Kolkata and Dehradun, in which it was 35%, 55% and 16.6% respectively which may be due to awareness and proper communication to the patients and care givers 21,22 .…”

Section: Discussionsupporting

confidence: 81%

“…In a study done in Finland in 1995, patients with high blood pressure who did not take their antihypertensive medication as recommended have a nearly fourfold increased risk of dying from a stroke by the second year and non-adherence was associated with 5.7-fold increased risk of fatal stroke during the year of death and a twofold increased risk of nonfatal stroke. 16,17,18 India has the largest number of diabetics and is considered as the "diabetes capital of the world". 19 The International Diabetes Federation (IDF) has estimated the total number of diabetic subjects to be around 40.9 million in India, which will further rise to 69.9 million by the year 2025.…”

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confidence: 99%

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Evaluation of Medication Adherence among Elderly Patients at the time of stroke Onset in Southeast Rajasthan

Sardana¹,

Kiran²

2019

Journal of the Indian Academy of Geriatrics

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Introduction: Stroke is the second most common cause of death worldwide after ischemic heart disease. Socioeconomic burden of stroke can be reduced by proper treatment of modifiable risk factors and maintaining adherence to treatment. The aim of this study is to identify factors associated with non-adherence to treatment of modifiable risk factors in elderly stroke patients. Methods: Prospective observational study with 100 acute ischemic stroke patients admitted in Neurology department, Government Medical College Kota between June to September 2018. Risk factors for stroke and reasons for non-adherence to anti-hypertensives, anti-diabetics and antiplatelet agents were studied in detail. Results: Various modifiable risk factors for stroke present in study subjects were smoking (35%), alcoholism (16%), hypertension (82%) and diabetes mellitus (23%). Past history of stroke was present in 14% cases. Total 59 patients were non-adherent to treatment. Reasons for non-adherence include poor knowledge (47%), superstitious belief (32%), intentional withdrawal (25%), due to miscommunication (12%), pill burden (7%), side effects (3%), pill size (1%) and poor family care(1%). Conclusions: Understanding of various factors associated with medication intake and creating awareness among patient could help in medication adherence.

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Section: Discussionsupporting

confidence: 81%

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confidence: 99%

Evaluation of Medication Adherence among Elderly Patients at the time of stroke Onset in Southeast Rajasthan

Sardana¹,

Kiran²

2019

Journal of the Indian Academy of Geriatrics

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“…54,55,59 Further, male patients had a higher likelihood of being in the RD trajectory as compared to the adherent trajectory. Prior research has demonstrated a higher adherence among females as compared to males on anti-hypertensive treatment [60][61][62] which illustrates the need to explore sex-specific barriers to medication adherence among older adults on ACEI/ARBs. Lastly, patients with no income subsidy were more likely to be in the GD trajectory.…”

Section: Discussionmentioning

confidence: 99%

<p>Group-Based Trajectory Modeling to Identify Patterns of Adherence and Its Predictors Among Older Adults on Angiotensin-Converting Enzyme Inhibitors (ACEIs)/Angiotensin Receptor Blockers (ARBs)</p>

Paranjpe¹,

Johnson²,

Essien³

et al. 2020

PPA

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Purpose: Commonly prescribed medications among patients with comorbid diabetes mellitus and hypertension include ARBs and ACEIs. However, these medications are associated with suboptimal adherence leading to inadequately controlled blood pressure. Unlike traditional single estimates of proportion of days covered (PDC), group-based trajectory modeling (GBTM) can graphically display the dynamic nature of adherence. The objective of this study was to evaluate adherence using GBTMs among patients prescribed ACEI/ARBs and identify predictors associated with each adherence trajectory. Patients and Methods: Patients with an ACEI/ARBs prescription were identified between July 2017 and December 2017 using a Medicare Advantage dataset. PDC was used to measure monthly patient adherence during the one-year follow-up period. The monthly PDC was added to a logistic group-based trajectory model to provide distinct patterns of adherence. Further, a multinomial logistic regression was conducted to determine predictors of each identified adherence trajectory. Predictors included various socio-demographic and clinical patient characteristics. Results: A total of 22,774 patients were included in the analysis and categorized into 4 distinct adherence trajectories: rapid decline (12.6%); adherent (58.5%); gaps in adherence (12.2%), and gradual decline (16.6%). Significant predictors associated with all lower adherence trajectories included 90 days refill, >2 number of other medications, ≥1 hospitalizations, and prevalent users. Significant predictors associated with the rapid decline trajectory included male sex, comorbidities, and increased CMS risk score. Further, significant predictors associated with the gaps in adherence trajectory included increasing age, and comorbidities. Lastly, significant predictors associated with the gradual decline trajectory included increasing age, no health plan subsidy, comorbidities, and increasing CMS risk score. Conclusion: Identifying various patient characteristics associated with non-adherent trajectories can guide the development of tailored interventions to enhance adherence to ACEI/ARBs.

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“…Chinese scholars have investigated patients with hypertensive stroke after discharge and found that their medication adherence was poor. Additionally, the results showed that patients had a lack of knowledge of hypertension (8). In addition, studies have shown that low medication adherence is associated with a higher rate of hospitalization and higher mortality in patients with cardiovascular disease (9).…”

Section: Introductionmentioning

confidence: 99%

Medication Literacy in a Cohort of Chinese Patients Discharged With Essential Hypertension

Zhong

Zheng

et al. 2020

Front. Public Health

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Background: In recent years, research on medication literacy has increased in many countries. Medication literacy in patients with essential hypertension affects the management and prognosis of hypertension. Method: This is a cross-sectional study of 147 discharged patients with essential hypertension who were treated at a tertiary hospital in Changsha, Hunan, China, between March and June 2016. The demographic and clinical data of the patients with hypertension were obtained from the medical records. The Chinese version of the Medication Literacy Questionnaire was applied to measure the medication literacy of hypertensive patients from 7 to 30 days after discharge by structured interview. Data were analyzed using SPSS version 19.0. Multiple linear regression was used to analyse the meaningful determinants of medication literacy. Results: The medication literacy of discharged patients with hypertension was poor. More than 70% of patients had no substantial knowledge of the effects and side effects of the medications they were taking, more than 30% of patients did not know the name or dose of the medication, and more than 20% of patients did not know how often to take the medication. Conclusion: It is necessary to conduct targeted health education for discharged patients with essential hypertension to reduce the risks of low medication literacy based on the determinants obtained in this study.

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Post-discharge evaluation of medication adherence and knowledge of hypertension among hypertensive stroke patients in northwestern China

Cited by 33 publications

References 52 publications

Evaluation of Medication Adherence among Elderly Patients at the time of stroke Onset in Southeast Rajasthan

Evaluation of Medication Adherence among Elderly Patients at the time of stroke Onset in Southeast Rajasthan

<p>Group-Based Trajectory Modeling to Identify Patterns of Adherence and Its Predictors Among Older Adults on Angiotensin-Converting Enzyme Inhibitors (ACEIs)/Angiotensin Receptor Blockers (ARBs)</p>

Medication Literacy in a Cohort of Chinese Patients Discharged With Essential Hypertension

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