Impact of changes in pill appearance in the adherence to angiotensin receptor blockers and in the blood pressure levels: a retrospective cohort study.
BMJ Open
; 7(3): e012586, 2017 03 30.
Article
em En
| MEDLINE
| ID: mdl-28363919
ABSTRACT
OBJECTIVE:
To assess the level of adherence to angiotensin receptor blockers (ARBs) in patients regularly attending a community pharmacy and the influence of a change in patients' adherence to pharmacological treatment.DESIGN:
Retrospective cohort study of a random sample of consecutive patients collecting their medication.SETTING:
40 community pharmacies in Alicante (Southeast Spain).PARTICIPANTS:
602 consecutive ≥18â years old patients following treatment with ARBs at least 3 previous refills were included. MAIN OUTCOMEMEASURES:
Prevalence of uncontrolled blood pressure (BP) and adherence to prescribed pharmacological treatment (measured through both the Batalla and the Morisky-Green tests). A multivariate Poisson regression model was used to estimate the adjusted risk ratio (RRa) for non-adherence to pharmacological treatment by the presence of a change in patient's adherence and other significant variables.RESULTS:
161/602 (13.7%) patients presented uncontrolled BP. According to the Morisky test, 410/602 (68.2%) patients were considered adherent to pharmacological treatment and 231/602 (38.4%) patients according to the Batalla test. According to the Morisky-Green test, in the multivariable analysis, patients with a previous change in pill appearance were less likely to be adherent than those patients with no change in their pharmacological treatment (RRa 0.45; CI 95% 0.22 to 0.90; p=0.024). Systolic BP was higher in patients with a change in pill appearance in the previous 3 refills (median BP 142â mmâ Hg; IQR 136-148) than in those who did not have a change (median BP 127â mmâ Hg; IQR 118-135; p<0.001).CONCLUSIONS:
There was a low percentage of adherence and nearly 15% of uncontrolled BP in patients who regularly collected their medication. Switching between pills of different appearances was associated with lower patient adherence to pharmacological treatment and a higher uncontrolled BP than no change in pharmacological treatment or change only in package but not in pill appearance.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Antagonistas de Receptores de Angiotensina
/
Hipertensão
/
Anti-Hipertensivos
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article