Target Organ Damage And The Long Term Effect of Nonadherence To Clinical Practice Guidelines In Patients With Hypertension: A Retrospective Cohort Study

Abegaz, TM; Tefera, YG; Abebe, TB

doi:10.1016/j.jval.2017.08.1168

Cited by 5 publications

(8 citation statements)

References 29 publications

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“…This is attributed to some cultural and social taboos that prohibit transparency and disclosure to clinicians. These clinicians’ traditional trend should be replaced by the clinical guideline recommendations to change the prescribing practice for better patient outcomes since guideline recommendations are better supported by clinical evidence and superior to individual preferences …”

Section: Introductionmentioning

confidence: 99%

Prescribing trend in cardiovascular patients at Ethiopian university hospital: The number of medications and implication on the clinical improvement

Tefera

Abebe

Mekuria

et al. 2019

Pharmacology Res & Perspec

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Investigating the prescribing trend is important to improve rational prescribing. This study aimed at assessing the cardiovascular drug use, pattern, and its impact on clinical outcome. A cross‐sectional study was employed in the outpatient department of chronic illness clinic of Gondar University specialized hospital, Ethiopia from 15 January 2017 to 15 March 2017. The independent variables were sociodemographic, medication, and other clinical information while cardiovascular disease improvement is the outcome variable. Binary logistic regression was used to test the association between the independent variables and the outcome variable. Kaplan Meier curve was used to analyze the clinical improvement while the Log‐rank test was employed to compare the clinical outcome with the number of medications. Eight hundred thirty‐three cardiovascular patient medical records were included in the final analysis. The majority (62.5%) of patients were females and more than 61% were above 50 years of age. Diuretics monotherapy accounted for a third (33.6%) of cardiovascular drug use, followed by combination therapy of angiotensin convertase enzyme inhibitors with Diuretics (21.8%) and calcium channel blockers with diuretics (8.3%). Cardiovascular patients followed for 72 months found to have a good level of clinical improvement on combination medication (Log Rank of 28.9, P = 0.000). In this study, diuretics monotherapy or in combination with angiotensin convertase enzyme inhibitors were found to be the frequently prescribed drugs in cardiovascular patients. Combination therapy has an implication for good cardiovascular improvement on long term follow‐up. It seems clinicians were restricted to certain cardiovascular medications while plenty of choices are available from the diverse classes of cardiovascular drugs.

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Section: Introductionmentioning

confidence: 99%

Prescribing trend in cardiovascular patients at Ethiopian university hospital: The number of medications and implication on the clinical improvement

Tefera

Abebe

Mekuria

et al. 2019

Pharmacology Res & Perspec

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“…Peningkatan tekanan darah dalam waktu yang lama menyebabkan kerusakan struktur dan fungsi berbagai organ 3 . Organ vital yang sering mengalami kerusakan akibat hipertensi adalah jantung, otak, mata dan ginjal 4,5 .…”

Section: Pendahuluanunclassified

“…Kerusakan pada ginjal terjadi karena peningkatan tekanan glomerulus, peningkatan glomerulus filtration rate (GFR) dan kerusakan nefron 6,7 . Efek kerusakan ginjal akibat hipertensi dapat terjadi asimptomatik sampai dengan kerusakan ginjal terminal 5 .…”

Section: Pendahuluanunclassified

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Left Ventricular Hypertrophy dan Fungsi Ginjal pada Penderita Hipertensi

2018

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Introduction: Chronic hypertension can cause complication such as left ventricular hypertrophy (LVH). LVH can lead renal artery vasoconstriction, impaire blood perfusion to glomerulus and change glomerulus filtration coeficient. The aim of this study was to compare kidney function between hypertensive patient with LVH and without LVH Methods: This was a case control study that conducted at Dr. Moewardi General Hospital Surakarta. All subjects has been diagnosed as hypertension more than 5 years. The diagnosis of LVH was based on electrocardiography (ECG) result. Kidney function was assessed based on serum ureum, creatinin, and uric acid levels. Results: The subject of this study was 26 hypertension patients with LVH and 13 hypertension patients without LVH. Serum ureum level in patients with LVH was higher than hypertension patients without LVH(24.92 ± 7.99 Vs 32.33±9.91, p= 0.004). Serum uric acid level in hypertension patients with LVH was higher compare to hypertension patients without LVH as well (5.26 ± 1.15 Vs 6.98 ± 1.83, p= 0.029). Whereas serum creatinine levels were not significantly different between two groups of subjects. Sulastomo et.al., Left Ventricular Hypertrophy dan Fungsi Ginjal pada Penderita Hipertensi Conclusion: : Serum ureum and uric acid levels in hypertensive subjects with LVH are higher than subjects without LVH. There is no difference between serum creatinin level in hypertensive subject with LVH and without LVH.

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“…During the 5 to 10 years of follow-up, less than 40% of p a t i e n t s c o n t i n u e d w i t h t h e i r p r e s c r i b e d antihypertensive treatment. (4,5).Other studies have reported numerous factors that affect adherence including lifestyle, psychological issues, health literacy, support systems and side effects of medications (6). This study was conducted in Buengkan province, which is the newest province of Thailand and is considered a rural area.…”

Section: Introductionmentioning

confidence: 99%

Self-Care Management Among Elderly Patients With Hypertension and Poor Adherence to Treatment, Living in Rural Thailand: A Qualitative Study

Woodham¹,

Taneepanichskul²,

Somrongthong³

et al. 2018

PJPH

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Background: Hypertension is a common health problem among the elderly. Approximately 50% have poor adherence to their prescribed medication, which leads to uncontrolled blood pressure. This study was aimed to understand causes of poor adherence and gain knowledge of patient's self-management in their home. Methods: In-depth interviews were conducted. Elderly hypertension patients with poor adherence to antihypertension medication and uncontrol blood pressure, between the ages of 60-79 were purposively selected to participate in this study. Home visits, including observation of patient's behavior in their home, were conducted. Content analysis was performed. Results: A total of thirty respondents were interviewed of which 17 were female and 13 were male. All understood that hypertension is a chronic health problem but most of them were unaware that nonadherence to their hypertension medication treatment would lead to negative consequence to their health. Most respondents had negative beliefs toward hypertension treatment. The reasons for poor adherence are: 1) personal beliefs or habits, which include forgetfulness and negative belief that the medication will not control blood pressure; 2) side effects of medication and 3) negative perceptions influenced by the community. Research results showed that most participants were not taking their prescribed dosage. Additionally, expired medication was commonly found in their medication inventory. High sodium diets and no regular exercise was commonly reported. Conclusion: Patients understood that hypertension is a lifelong condition but unaware of consequence of poor adherence. Personal reason and negative belief as well as wrong belief influenced by community. Forgetfulness and manage dosage of medication should be addressed when designing a strategy to improve medical adherence. Education on controlling hypertension and treatments should be addressed and incorporated into a holistic strategy to improve adherence to the patient's drug regimen.

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Target Organ Damage And The Long Term Effect of Nonadherence To Clinical Practice Guidelines In Patients With Hypertension: A Retrospective Cohort Study

Cited by 5 publications

References 29 publications

Prescribing trend in cardiovascular patients at Ethiopian university hospital: The number of medications and implication on the clinical improvement

Prescribing trend in cardiovascular patients at Ethiopian university hospital: The number of medications and implication on the clinical improvement

Left Ventricular Hypertrophy dan Fungsi Ginjal pada Penderita Hipertensi

Self-Care Management Among Elderly Patients With Hypertension and Poor Adherence to Treatment, Living in Rural Thailand: A Qualitative Study

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