Volume 26, Issue 2 (Avicenna Journal of Clinical Medicine-Summer 2019)                   Avicenna J Clin Med 2019, 26(2): 83-92 | Back to browse issues page

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1- , salari@iaut.ac.ir
Abstract:   (3760 Views)
Background and Objective: Adherence to antihypertension medications is an important factor in the control of hypertension. In this regard, the present study aimed to estimate the extent of medication adherence in hypertensive patients and its determinants in the special clinic of Seyed-al Shohada Cardiovascular Tertiary Hospital in Urmia, Iran.
Materials and Methods: In this cross-sectional study, a total of 650 hypertensive patients were investigated during October to December 2016. In this study, two questionnaires were used to collect the data. The first questionnaire included the demographic and clinical characteristics, smoking status, family history of hypertension, and blood pressure measurements. The eight-item Morisky medication adherence scale was used to measure the extent of medication adherence of the participants. Moreover, the Chi-square test and logistic regression model were employed to identify the determinants of medication adherence.
Results: Mean value of the participant age was reported as 59.5±10.4 years, and 63.5% of the subjects were female. Overall, 48%, 30.8%, and 21.2% of the subjects were reported with complete, moderate, and poor adherence, respectively. Among the investigated determinants, age (OR=1.02, 95% CI: 1.01-1.05), occupational status (OR=1.83, 95% CI: 1.19-2.83), absence of adverse effects of the drugs (OR=1.83, 95% CI: 1.02-2.71), use of two drugs (OR=1.75, 95% CI: 1.12-2.74), use of three drugs and more (OR=2.25, 95% CI: 1.30-3.88), and history of angioplasty (OR=1.80, 95% CI: 1.19-2.71) were associated with good adherence (i.e., complete and moderate) in this study. Only 39.4% of all participants had controlled level of hypertension.
Conclusion: According to the obtained results, the patients with hypertension had good medication adherence. The determinants effective in medication adherence outlined in this study can help identify patients with low extent of adherence.
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Type of Study: Original | Subject: Biostatistics & Epidemiology

1. Vasan RS, Larson MG, Leip EP, Evans JC, O'Donnell CJ, Kannel WB, et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. N Eng J Med. 2001;345(18):1291-7. PMID: 11794147 DOI: 10.1056/NEJMoa003417
2. Dodu SR. Emergence of cardiovascular diseases in developing countries. Cardiology. 1988;75(1):56-64. PMID: 3342425 DOI: 10.1159/000174349
3. Nissinen A, Böthig S, Granroth H, Lopez AD. Hypertension in developing countries. World Health Stat Q. 1988;41(3-4):141-54. PMID: 2466378
4. Omran AR. The epidemiologic transition: a theory of the epidemiology of population change 1971. Milbank Q. 2005;83(4):731-57. PMID: 16279965 DOI: 10.1111/j.1468-0009.2005.00398.x
5. Akinkugbe O. World epidemiology of hypertension in blacks. J Clin Hypertens. 1987;3(3 Suppl):1S-8S. PMID: 3668598
6. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42(6):1206-52. PMID: 14656957 DOI: 10.1161/01.HYP.0000107251.49515.c2
7. Shrivastava SR, Shrivastava PS, Ramasamy J. The determinants and scope of public health interventions to tackle the global problem of hypertension. Int J Prev Med. 2014;5(7):807-12. PMID: 25104990
8. Hadi N, Rostami GN. Determinant factors of medication compliance in hypertensive patients of Shiraz, Iran. Arch Iran Med. 2004;7(4):292-6.
9. Rudd P. Medication compliance for antihypertensive therapy, Hypertension. St Louis, MO, USA: WB Saunders; 2000. P. 419-31.
10. De Geest S, Sabaté E. Adherence to long-term therapies: evidence for action. Eur J Cardiovasc Nurs. 2003;2(4):323. PMID: 14667488 DOI: 10.1016/S1474-5151(03)00091-4
11. DiMatteo MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care. 2004;42(3):200-9. PMID: 15076819 DOI: 10.1097/01.mlr.0000114908.90348.f9
12. Psaty BM, Koepsell TD, Wagner EH, LoGerfo JP, Inui TS. The relative risk of incident coronary heart disease associated with recently stopping the use of β-blockers. JAMA. 1990;263(12):1653-7. PMID: 1968518
13. Sokol MC, McGuigan KA, Verbrugge RR, Epstein RS. Impact of medication adherence on hospitalization risk and healthcare cost. Med Care. 2005;43(6):521-30. PMID: 15908846 DOI: 10.1097/01.mlr.0000163641.86870.af
14. Márquez Contreras E, Gil Guillén V, Casado Martínez JJ, Martel Claros N, De la Figuera von Wichmann M, Martín de Pablos JL, et al. Analysis of studies published on hypertension treatment non-compliance in Spain between 1984 and 2005. Aten Primaria. 2006;38(6):325-32. PMID: 17173796 DOI: 10.1157/13093369
15. Sackett DL, Haynes RB. Compliance with therapeutic regimens. Baltimore, MD: John Hopkins University Press; 1976.
16. Norman SA, Marconi KM, Schezel GW, Schechter CF, Stolley PD. Beliefs, social normative influences, and compliance with antihypertensive medication. Am J Prev Med. 1985;1(3):10-7. PMID: 3870899
17. Moharamzad Y, Saadat H, Nakhjavan Shahraki B, Rai A, Saadat Z, Aerab-Sheibani H, et al. Validation of the persian version of the 8-item morisky medication adherence scale (MMAS-8) in Iranian hypertensive patients. Glob J Health Sci. 2015;7(4):173-83. PMID: 25946926 DOI: 10.5539/gjhs.v7n4p173
18. Wolf-Maier K, Cooper RS, Kramer H, Banegas JR, Giampaoli S, Joffres MR, et al. Hypertension treatment and control in five European countries, Canada, and the United States. Hypertension. 2004;43(1):10-7. PMID: 14638619 DOI: 10.1161/01.HYP.0000103630.72812.10
19. Al-Ruthia YS, Hong SH, Graff C, Kocak M, Solomon D, Nolly R. Examining the relationship between antihypertensive medication satisfaction and adherence in older patients. Res Social Adm Pharm. 2017;13(3):602-13. PMID: 27493129 DOI: 10.1016/j.sapharm.2016.06.013
20. Alsolami F, Correa-Velez I, Hou XY. Factors affecting antihypertensive medications adherence among hypertensive patients in Saudi Arabia. Am J Med Med Sci. 2015;5(4):181-9. DOI: 10.5923/j.ajmms.20150504.07
21. Kang CD, Tsang PP, Li WT, Wang HH, Liu KQ, Griffiths SM, et al. Determinants of medication adherence and blood pressure control among hypertensive patients in Hong Kong: a cross-sectional study. Int J Cardiol. 2015;182:250-7. PMID: 25585359 DOI: 10.1016/j.ijcard.2014.12.064
22. Lee GK, Wang HH, Liu KQ, Cheung Y, Morisky DE, Wong MC. Determinants of medication adherence to antihypertensive medications among a Chinese population using Morisky Medication Adherence Scale. PLoS One. 2013;8(4):e62775. PMID: 23638143 DOI: 10.1371/journal.pone.0062775
23. Yassine M, Al-Hajje A, Awada S, Rachidi S, Zein S, Bawab W, et al. Evaluation of medication adherence in Lebanese hypertensive patients. J Epidemiol Glob Health. 2016;6(3):157-67. PMID: 26232704 DOI: 10.1016/j.jegh.2015.07.002
24. Yue Z, Bin W, Weilin Q, Aifang Y. Effect of medication adherence on blood pressure control and risk factors for antihypertensive medication adherence. J Eval Clin Pract. 2015;21(1):166-72. PMID: 25318567 DOI: 10.1111/jep.12268
25. Al-Ramahi R. Adherence to medications and associated factors: A cross-sectional study among Palestinian hypertensive patients. J Epidemiol Glob Health. 2015;5(2):125-32. PMID: 25922321 DOI: 10.1016/j.jegh.2014.05.005
26. Bramley TJ, Gerbino PP, Nightengale BS, Frech-Tamas F. Relationship of blood pressure control to adherence with antihypertensive monotherapy in 13 managed care organizations. J Manag Care Pharm. 2006;12(3):239-45. PMID: 16623608 DOI: 10.18553/jmcp.2006.12.3.239
27. Khalil SA, Elzubier AG. Drug compliance among hypertensive patients in Tabuk, Saudi Arabia. J Hypertens. 1997;15(5):561-5. PMID: 9170010 DOI: 10.1097/00004872-199715050-00013
28. Krousel-Wood M, Islam T, Webber LS, Re RN, Morisky DE, Muntner P. New medication adherence scale versus pharmacy fill rates in seniors with hypertension. Am J Manag Care. 2009;15(1):59-66. PMID: 19146365
29. Lam PW, Lum CM, Leung MF. Drug non-adherence and associated risk factors among Chinese geriatric patients in Hong Kong. Hong Kong Med J. 2007;13(4):284-92. PMID: 17664533
30. Li WW, Kuo CT, Hwang SL, Hsu HT. Factors related to medication non-adherence for patients with hypertension in Taiwan. J Clin Nurs. 2012;21(13-14):1816-24. PMID: 22672451 DOI: 10.1111/j.1365-2702.2012.04088.x
31. Saleem F, Hassali MA, Shafie AA, Awad GA, Atif M, ul Haq N, et al. Does treatment adherence correlates with health related quality of life? Findings from a cross sectional study. BMC Public Health. 2012;12:318. PMID: 22545950 DOI: 10.1186/1471-2458-12-318
32. Song Y, Han HR, Song HJ, Nam S, Nguyen T, Kim MT. Psychometric evaluation of hill-bone medication adherence subscale. Asian Nurs Res (Korean Soc Nurs Sci). 2011;5(3):183-8. PMID: 25030368 DOI: 10.1016/j.anr.2011.09.007
33. Hashmi SK, Afridi MB, Abbas K, Sajwani RA, Saleheen D, Frossard PM, et al. Factors associated with adherence to anti-hypertensive treatment in Pakistan. PLoS One. 2007;2(3):e280. PMID: 17356691 DOI: 10.1371/journal.pone.0000280
34. Billups SJ, Malone DC, Carter BL. The relationship between drug therapy noncompliance and patient characteristics, health-related quality of life, and health care costs. Pharmacotherapy. 2000;20(8):941-9. PMID: 10939555
35. Svensson S, Kjellgren KI, Ahlner J, Saljo R. Reasons for adherence with antihypertensive medication. Int J Cardiol. 2000;76(2-3):157-63. PMID: 11104870 DOI: 10.1016/s0167-5273(00)00374-0
36. Hill MN, Bone LR, Kim MT, Miller DJ, Dennison CR, Levine DM. Barriers to hypertension care and control in young urban black men. Am J Hypertens. 1999;12(10 Pt 1):951-8. PMID: 10560780 DOI: 10.1016/s0895-7061(99)00121-1
37. Col N, Fanale JE, Kronholm P. The role of medication noncompliance and adverse drug reactions in hospitalizations of the elderly. Arch Intern Med. 1990;150(4):841-5. PMID: 2327844

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