Non-adherence to antihypertensive medication: The role of mental and physical comorbidity.
Int J Cardiol
; 207: 310-6, 2016 Mar 15.
Article
in En
| MEDLINE
| ID: mdl-26814635
ABSTRACT
BACKGROUND:
Multiple parameters influence adherence to drug treatment, including socio-economic, healthcare, condition, therapy, and patient-related factors. However, studies of the impact of patient-related factors, particularly regarding comorbid conditions, have produced conflicting results.OBJECTIVES:
To analyse the association between mental and physical comorbidity and non-adherence to antihypertensive medication in patients attending primary care, after including a comprehensive range of chronic comorbidities and potential confounders.METHODS:
Cross-sectional study of 113,397 adults with a diagnosis of hypertension in 2010 assigned to the public health service of a region in northeastern Spain. Pharmacy billing records were linked to data from electronic health records at individual level. Non-adherence was defined as an antihypertensive medication possession ratio (MPR) <80%. Multivariable logistic regression models were used to estimate the odds ratio for non-adherence. Potential predictors included mental and physical comorbidity, age, sex, blood pressure level, nationality, rurality, polypharmacy, and number of visits to the GP and to different specialties.RESULTS:
One fifth of the study population showed poor adherence levels. Female sex, younger age, foreign nationality, living in a rural area, low blood pressure levels, polypharmacy, and mental comorbidity were positively and significantly associated with non-adherence. Conversely, non-adherence was negatively and significantly associated with the presence of cardiovascular risk factors and higher annual rates of GP visits.CONCLUSION:
The majority of patient-related determinants identified here (e.g., the presence of mental comorbidity, polypharmacy, foreign nationality) underscores the need for a patient- rather than a disease-centred care approach, as well as adequate physician-patient communication.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Communication Barriers
/
Medication Adherence
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Hypertension
/
Mental Disorders
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Antihypertensive Agents
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
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Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
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Aged80
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Year:
2016
Type:
Article