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      La adhesión al tratamiento antihipertensivo es de fundamental importancia Translated title: Adhering to antihypertensive treatment is vitally important

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          Abstract

          Introducción: La hipertensión es uno de los factores de riesgo cardiovascular más frecuentes y el índice de adhesión al tratamiento entre los pacientes hipertensos es bajo. Objetivos: Elaborar, validad y evaluar la fiabilidad del Medication Adherence Questionnaire (MAQ) en pacientes hipertensos. Materiales y métodos: Se llevó a cabo un estudio transversal durante ocho meses en pacientes hipertensos atendidos en el Departamento de Medicina General. El MAQ fue elaborado con referencia a cuestionarios validados con anterioridad y de acuerdo con lo hallado en otros estudios relacionados con la adhesión al tratamiento farmacológico. La validación del MAQ fue realizada por el comité de expertos y analizada en términos de fiabilidad prueba-repetición de la prueba. La información sobre la adhesión al tratamiento farmacológico fue recabada mediante la evaluación de los pacientes que habían recibido al menos una droga antihipertensiva durante los últimos tres meses. Resultados: El puntaje medio correspondiente a la adhesión al tratamiento ante la prueba y la reiteración de la prueba fue 66.25 ± 19.49 y 67.5 ± 19.19, respectivamente, y la fiabilidad del MAQ fue 0.979. De los 299 pacientes, 180 (60.2%) fueron de sexo masculino y 118 (39.46%) fueron de sexo femenino. En nuestra población en estudio, la mayoría de los pacientes presentaron un nivel intermedio de adhesión al tratamiento farmacológico (53.84%), seguido por el nivel bajo (39.13%) y elevado de adhesión al tratamiento farmacológico (7.02%). Conclusión: El cuestionario autoadministrado MAQ de ocho ítems fue creado y evaluado en términos de fiabilidad en pacientes hipertensos residentes en el sur de la India. El puntaje medio correspondiente a la adhesión al tratamiento farmacológico en la población en estudio fue 71.77 ± 13.94, lo cual indica un nivel bajo de adhesión al tratamiento con drogas antihipertensivas.

          Translated abstract

          Introduction: Hypertension is one of the most common cardiovascular risk factors but the medication adherence rate among hypertensive patients is low. Objectives: To develop, validate and test the reliability of the Medication Adherence Questionnaire (MAQ) in hypertensive patients. Materials and methods: A cross-sectional study was conducted among hypertensive patients in the Department of General Medicine for eight months. The MAQ was prepared by referring to previously validated questionnaires and other related medication adherence studies. It was validated by the expert committee and tested for test-retest reliability. The medication adherence data was collected from patients who had received at least one antihypertensive medication in the past three months. Results: The mean medication adherence score for the test and re-test were 66.25 + 19.49 and 67.50 + 19.19 respectively, and the test-retest reliability of MAQ was 0.979. Out of 299 patients, 180 (60.20%) were males, and 118 (39.46%) were females. In our study population, most of the patients were found to have medium medication adherence (53.84%) followed by low medication adherence (39.13%) and high medication adherence (7.02%). Conclusion: The self-reported 8-item MAQ was developed and tested for reliability in South Indian hypertensive patients.The mean medication adherence of the study population was 71.77 + 13.94, which indicates low medication adherence to antihypertensive treatment.

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          Most cited references21

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          Epidemiology of coronary heart disease and acute coronary syndrome.

          The aim of this review is to summarize the incidence, prevalence, trend in mortality, and general prognosis of coronary heart disease (CHD) and a related condition, acute coronary syndrome (ACS). Although CHD mortality has gradually declined over the last decades in western countries, this condition still causes about one-third of all deaths in people older than 35 years. This evidence, along with the fact that mortality from CHD is expected to continue increasing in developing countries, illustrates the need for implementing effective primary prevention approaches worldwide and identifying risk groups and areas for possible improvement.
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            Medication adherence among hypertensive patients of primary health clinics in Malaysia

            Purpose Poor adherence to prescribed medications is a major cause for treatment failure, particularly in chronic diseases such as hypertension. This study was conducted to assess adherence to medications in patients undergoing hypertensive treatment in the Primary Health Clinics of the Ministry of Health in Malaysia. Factors affecting adherence to medications were studied, and the effect of nonadherence to blood pressure control was assessed. Patients and methods This was a cross-sectional study to assess adherence to medications by adult patients undergoing hypertensive treatment in primary care. Adherence was measured using a validated survey form for medication adherence consisting of seven questions. A retrospective medication record review was conducted to collect and confirm data on patients’ demographics, diagnosis, treatments, and outcomes. Results Good adherence was observed in 53.4% of the 653 patients sampled. Female patients were found to be more likely to adhere to their medication regime, compared to their male counterparts (odds ratio 1.46 [95% confidence intervals [CI]: 1.05–2.04; P < 0.05]). Patients in the ethnic Chinese were twice as likely (95% CI: 1.14–3.6; P < 0.05) to adhere, compared to those in the Indian ethnic group. An increase in the score for medicine knowledge was also found to increase the odds of adherence. On the other hand, increasing the number of drugs the patient was taking and the daily dose frequencies of the medications prescribed were found to negatively affect adherence. Blood pressure control was also found to be worse in noncompliers. Conclusion The medication adherence rate was found to be low among primary care hypertensive patients. A poor adherence rate was found to negatively affect blood pressure control. Developing multidisciplinary intervention programs to address the factors identified is necessary to improve adherence and, in turn, to improve blood pressure control.
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              The eight-item Morisky Medication Adherence Scale MMAS: translation and validation of the Malaysian version.

              To translate and examine the psychometric properties of the Malaysian version of the Morisky Medication Adherence Scale (MMAS) among patients with type 2 diabetes. A standard "forward-backward" procedure was used to translate MMAS into Malay language. It was later validated on a convenience sample of 223 type 2 diabetes outpatients between May and September 2009. Reliability was tested for internal consistency. Validity was confirmed using convergent and known group validity. Employing the recommended scoring method, the mean±SD of MMAS scores was 6.13±1.72. Moderate internal consistency was found (Cronbach's α=0.675), the test-retest reliability value was 0.816 (p<0.001). A positive correlation between the eight- and four-item MMAS was found (r=0.792; p<0.01). A significant relationship between MMAS categories and HbA1c categories (χ(2)=20.261; p≥0.001) was found. The MMAS sensitivity and specificity, with positive and negative predictive values were 77.61%, 45.37%, 46.84% and 76.56%, respectively. The findings of this validation study indicate that the Malaysian version of the MMAS is a reliable and valid measure of medication adherence which can now be used. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                siic
                Salud(i)Ciencia
                Salud(i)Ciencia
                Sociedad Iberoamericana de Informaciòn cientìfica (Ciudad autonoma de Buenos Aires, , Argentina )
                1667-8682
                1667-8990
                April 2019
                : 23
                : 4
                : 1-10
                Affiliations
                [1] orgnameInstitute of Pharmaceutical Sciences India
                [2] Karnataka Mangalore orgnameHegde Medical Academy India
                Article
                S1667-89902019000100001
                10.21840/siic/157368
                6a59d579-5f89-4776-9f6b-5b0158c59c06

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 14 March 2018
                : 21 December 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 27, Pages: 10
                Product

                SciELO Argentina

                Categories
                Artìculos originales

                hipertensión,adhesión a la medicación,presión arterial,tratamiento,enfermedad crónica,hypertension,medication adherence,blood pressure,treatment,chronic disease

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