Relación entre el control de la presión arterial y la adherencia al tratamiento medida mediante el sistema de receta XXI en Granada (España) / Relationship between blood pressure control and treatment adherence measured using the electronic prescription in Granada (Spain)

Introducción: La adherencia al tratamiento ha sido identificada como uno de los factores más importantes para conseguir valores de presión arterial adecuados en pacientes hipertensos. Objetivo: Describir cuál es la adherencia de los pacientes al tratamiento antihipertensivo determinada mediante los registros de retirada de medicamentos por prescripción electrónica (Receta XXI) y estudiar la relación que existe entre dicha adherencia y el control de la presión arterial (PA). Método: Descriptivo transversal desde mayo de 2017 hasta mayo de 2019, en 6 farmacias comunitarias de la provincia de Granada (España). Se incluyeron pacientes mayores de 18 años que tomaban al menos un medicamento antihipertensivo durante un mínimo de 6 meses. Variables principales: Control de la presión arterial y adherencia al tratamiento antihipertensivo mediante el Sistema Receta XXI. Resultados: 95 pacientes fueron incluidos en el estudio. 49 (51,6%) no tenían controlada la PA y 29 (30.5%) paciente mostraron tener una adherencia sub-óptima. El análisis multivariante mostró que el grado de adherencia no estaba asociado a ninguna de las variables incluidas en el estudio y el control de la PA sólo estuvo relacionado con el sexo (OR: 0,044; IC95%: 0,005-0,427), con haber padecido arritmia cardiaca (OR: 0,004; IC95%: 0,000-0,106) y con padecer ansiedad (OR: 0,109; IC95%: 0,013-0,933). Conclusión: La prevalencia de hipertensión arterial no controlada fue muy elevada (51,6%) y no hubo asociación con factores de riesgo sociodemográficos habituales como la actividad física, tabaquismo o IMC. La falta de adherencia al tratamiento también tuvo una prevalencia muy alta (30.5%) sin embargo no mostró ser factor de riesgo PA no controlada. (AU)

Background: Treatment adherence has been identified as one of the most relevant factors in achieving adequate blood pressure values in hypertensive patients. Aims: To describe patient adherence to antihypertensive treatment determined by drug collection records of the electronic prescription system and study the relationship between this adherence and blood pressure control. Methods: Cross-sectional study conducted from May 2017 to May 2019, in 6 community pharmacies in the province of Granada (Spain). Patients over 18 years of age who took at least one antihypertensive medication for at least six months were included. Main outcome measure: Blood pressure control and adherence to antihypertensive treatment using the electronic prescription. Results: A total of 95 patients were included in the study. A total of 49 patients (51.6%) showed no blood pressure control, and 29 patients (30.5%) showed suboptimal adherence. The multivariate analysis showed no association between the degree of adherence and the variables included in the study, and blood pressure control was only related to sex (OR: 0.044; 95%CI: 0.005-0.427), to cardiac arrhythmia (OR: 0.004; 95% CI: 0.000-0.106) and to anxiety (OR: 0.109; 95% CI: 0.013-0.933). Conclusion: The prevalence of uncontrolled blood pressure was very high (51.6%), and no association with common sociodemographic risk factors, such as physical activity, smoking, or body mass index, was found. Non-adherence to treatment also had a very high prevalence (30.5%), but it was not associated with disease control. (AU)

Questionnaires on adherence to antihypertensive treatment: a systematic review of published questionnaires and their psychometric properties.

Background Non-adherence to antihypertensive treatment is currently considered one of the most significant risk factors in failure to achieve controlled blood pressure values. It is therefore extremely important to measure patient adherence to antihypertensive treatment. One way to measure adherence is through questionnaires. Numerous questionnaires for measuring adherence to antihypertensive treatment have been validated, but it not easy to choose one of them as being more appropriate than all of the others. Aim of the review The aim of this study was to identify and assess questionnaires designed to measure non-adherence to antihypertensive treatment, and to discuss their psychometric properties. Method A systematic review of the literature contained in PubMed and Scopus databases was undertaken to identify validated questionnaires on adherence to antihypertensive treatment up to October 2017. PRISMA guidelines were followed to conduct and report this review. Selection of articles and data extraction were performed by two independent researchers. When there was lack of agreement, a third researcher mediated in the discussion between the first two authors so that consensus could be reached. Results 39 articles were obtained containing 17 different questionnaires for measuring adherence to antihypertensive treatment. These questionnaires were validated in 15 countries. The number of items in the questionnaires ranged from three in QAM-Q to 33 in TAQPH. Hill-Bone compliance to high blood pressure therapy scale, Morisky-Green-Levine test and an 8-item Self-Reported Medication Adherence Measurement were the most widely validated questionnaires. Validity was analyzed more than reliability. Many of the questionnaires do not provide information on content validity. Construct validity and concurrent validity are analyzed in almost all of the questionnaires, and give highly variable results. By contrast, known-groups validity was not analyzed to any great degree. As regards reliability, almost all of the questionnaires provided Cronbach's alpha information with reasonably acceptable results, but temporal stability was not analyzed to any great degree. Conclusion None of the questionnaires included in the review demonstrates fulfilling all of the validity tests (content validity, construct validity and criterion-related validity) and reliability tests (homogeneity and temporal stability) in an acceptable manner. Therefore, none of them can be considered a Gold Standard.

Fiabilidad de los cuestionarios utilizados en ciencias de la salud / Reliability of the questionnaires used in the health sciences

La entrevista al paciente es una de las actividades más frecuentes en la actividad biomédica. Es necesario ayudarse de herramientas que faciliten la recolección de los datos de una forma oportuna. Esta es una de las razones por la que se utilizan cuestionarios. No obstante, para que un cuestionario, pueda ser considerado útil, existen ciertas características que debe cumplir, como es su validez y fiabilidad. La consistencia interna, el test retest y la fiabilidad inter-observador son pruebas que demuestran que un cuestionario es fiable. Todas ellas deben ser demostradas con el fin de asegurar que los valores obtenidos son repetibles. Por esta razón, estas propiedades deberían ser comprobadas en cada muestra de estudio para asegurar la bondad de los resultados y apoyar la evidencia existente de que es una buena herramienta de medida o no

The interview is one of the most frequently used strategies in health research. Tools which help to obtain accurate data are essential. This is why questionnaires are used. However, a questionnaire is considered useful only if it has certain characteristics such as validity and reliability. Internal consistency, test- retest and inter-observer reliability are evidence that a questionnaire is reliable. All of the above must be demonstrated in order to ensure reproducible results. These properties should be tested in each study sample, to ensure the reproducibility of the results and support the existing evidence that the tool is a good measurement or not

Validez de los cuestionarios utilizados en ciencias de la salud / Validity of the questionnaires used in the health sciences

Los farmacéuticos comunitarios se están incorporando a la investigación biomédica. Para esto suelen utilizar herramientas de medida. Una de las más utilizadas son los cuestionarios. No obstante, para que un cuestionario, pueda ser considerado útil, existen ciertas características que debe cumplir, como es su validez y fiabilidad. Tradicionalmente la validez de una escala se ha dividido en validez de contenido, validez aparente, validez de criterio y validez de constructo. Todas ellas deben ser demostradas con el fin de asegurar que los valores obtenidos representan de forma fidedigna la realidad estudiada. Por esta razón, estas propiedades deberían ser comprobadas en cada muestra de estudio para asegurar la bondad de los resultados y apoyar la evidencia existente de que es una buena herramienta de medida o no

Community pharmacists are getting incorporated to biomedical research. Measurements tools are often used. One of the most used is questionnaires. However, a questionnaire is useful if it has certain characteristics such as validity and reliability. Traditionally the validity of a scale is divided into "content validity", "face validity", "criterion validity" and "construct validity". In order to ensure that obtained values represent faithfully the studied facts, all of them must be demonstrated. For this reason, these properties should be checked in each study sample, to ensure the accuracy of the results and support the existing evidence that is a good measurement tool or not

Medida de adherencia al tratamiento en pacientes con hiperuricemia o gota / No disponible

Objetivos: Medir la adherencia a los medicamentos antigotosos en pacientes con hiperuricemia o gota y determinar los factores asociados a la adherencia en el tratamiento antigotoso. Método: Estudio observacional descriptivo transversal llevado a cabo en Farmacia Gómez Parera, Armilla (Granada). Se incluyeron pacientes mayores de 18 años con prescripción médica para el tratamiento de la hiperuricemia o gota. Se midió la uricemia (Refloton®) y la adherencia al tratamiento mediante el cuestionario BMQ (The Brief Medication Questionnaire). Se realizó un análisis de regresión logística multivariante para estudiar la relación entre la uricemia y los distintos factores asociados. Resultados: Se incluyeron 19 pacientes, donde el 89,5% fueron hombres. La media de edad fue de 65,5 (DE: 12,94) años. El valor medio de uricemia fue de 6,03 (DE 2,06). Como resultado del BMQ se obtuvo que solo 10,5% era adherente al tratamiento antigotoso y por cada punto de aumento en el recuento del BMQ, aumenta por término medio 2,65 mg/dl el AU en sangre. Las variables incluidas explicaron un 64,1% de la variabilidad de la uricemia en el modelo. Conclusiones: Los pacientes que toman medicamentos para la gota o la hiperuricemia, tienen baja adherencia al tratamiento y los valores de AU en sangre están relacionados con el grado de adherencia al tratamiento de estos pacientes (AU)

Aim: To measure the gout medication adherence in patients with hyperuricemia or gout and to determine the factors associated with adherence to anti-gout treatment. Method: Cross-sectional observational study conducted in Pharmacy Gomez Parera, Armilla (Granada). We included patients older than 18 with medical prescription to treat hyperuricemia or gout. Uric acid was measured (Refloton ®) and adherence to treatment by the questionnaire BMQ (The Brief Medication Questionnaire). Performed a multivariate logistic regression analysis to study the relationship between serum uric acid and the various associated factors. Results: We included 19 patients, where 89.5% were men. The mean age was 65.5 (SD: 12.94) years. The average value was 6.03 uricemia (SD 2.06). BMQ as a result it was found that only 10.5% were adherent and anti-gout treatment for each point increase in the count of BMQ increases averaged 2.65 mg / dl blood AU. The variables included explained 64.1% of the variability in the model uricemia. Conclusions: Patients who take medicine for gout or hyperuricemia, have low adherence to therapy and blood AU values are related to the degree of adherence to treatment of these patients (AU)