Relationship between blood pressure control and treatment adherence measured using the electronic prescription in Granada (Spain)
DOI:
https://doi.org/10.30827/ars.v63i1.22325Keywords:
Community Pharmacy Services; Electronic Prescription; High blood pressure; Treatment Adherence; Pharmaceutical Services; Pharmacies.Abstract
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.
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Mancia G, Rosei EA, Azizi M, Burnier M, Clement DL, Coca A, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;3021–2104. Doi:10.1093/eurheartj/ehy339
Timmis A, Townsend N, Gale C, Grobbee R, Maniadakis N, Flather M, et al. European Society of Cardiology: Cardiovascular Disease Statistics 2017. Eur Heart J. 2018;39:508–79. Doi: 10.1093/eurheartj/ehx628
Vrijens B, De Geest S, Hughes DA, Przemyslaw K, Demonceau J, Ruppar T, et al. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol. 2012;73:691–705. Doi:10.1111/j.1365-2125.2012.04167.x
Herttua K, Tabák AG, Martikainen P, Vahtera J, Kivimäki M. Adherence to antihypertensive therapy prior to the first presentation of stroke in hypertensive adults: population-based study. Eur Heart J. 2013;34:2933–9. Doi: 10.1093/eurheartj/eht219
Van der Laan DM, Elders PJM, Boons CCLM, Beckeringh JJ, Nijpels G, Hugtenburg JG. Factors associated with antihypertensive medication non-adherence: a systematic review. J Hum Hypertens. 2017;31:687–94. Doi:10.1038/jhh.2017.48
Costa FV. Improving Adherence to Treatment and Reducing Economic Costs of Hypertension: The Role of Olmesartan-Based Treatment. High Blood Press Cardiovasc Prev. 2017;24:265–74. doi: 10.1007/s40292-017-0221-4
Poulter NR, Borghi C, Parati G, Pathak A, Toli D, Williams B, et al. Medication adherence in hypertension. J Hypertens. 2020;38:579–87. Doi: 10.1093/eurheartj/ehy339
Vrijens B, Antoniou S, Burnier M, de la Sierra A, Volpe M. Current Situation of Medication Adherence in Hypertension. Front Pharmacol. 2017;8:100. Doi:10.3389/fphar.2017.00100
Hargrove JL, Pate V, Casteel CH, Golightly YM, Loehr LR, Marshall SW, et al. Antihypertensive Adherence Trajectories Among Older Adults in the First Year After Initiation of Therapy. Am J Hypertens. 2017;30:1015–23. Doi: 10.1093/ajh/hpx086
Lam WY, Fresco P. Medication Adherence Measures: An Overview. Biomed Res Int. 2015;2015:217047. Doi: 10.1155/2015/217047
Osterberg L, Blaschke T. Adherence to medication. N Engl J Med.2005;353:487–97. Doi:10.1056/NEJMra050100
Pareja-Martínez E, Esquivel-Prados E, Martínez-Martínez F, García-Corpas JP. Questionnaires on adherence to antihypertensive treatment: a systematic review of published questionnaires and their psychometric properties. Int J Clin Pharm 2020;42:355-365. Doi:10.1007/s11096-020-00981-x
Sendra-Lillo J, Martínez-Martínez F, García-Corpas JP, Marín Rivas F, Sabater-Hernández D. Validity of home blood pressure measurements manually registered by patients after an educational session provided by community pharmacists. Blood Press Monit. 2015;20:232–6. Doi: 10.1097/MBP.0000000000000119
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 Practice Guidelines for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. Blood Press. 2018;27:314–40. Doi: 10.1080/08037051.2018.1527177.
Márquez-Contreras E, López García-Ramos L de, Martell-Claros N, Gil-Guillen VF, Márquez-Rivero S, Pérez-López E, et al. Validation of the electronic prescription as a method for measuring treatment adherence in hypertension. Patient Educ Couns. 2018;101:1654–60. Doi:10.1016/j.pec.2018.04.009
Rubio Castañeda FJ, Tomás Aznar C, Muro Baquero C. Validity, Reliability and Associated Factors of the International Physical Activity Questionnaire Adapted to Elderly (IPAQ-E). Rev Esp Salud Publica. 18 de enero de 2017;91. Doi: 91:e201701004
Reuter H, Jordan J. Status of hypertension in Europe. Curr Opin Cardiol. 2019;34:342–9. Doi: 10.1097/HCO.0000000000000642
Beaney T, Schutte AE, Tomaszewski M, Ariti C, Burrell LM, Castillo RR, et al. May Measurement Month 2017: an analysis of blood pressure screening results worldwide. Lancet Glob Health 2018;6:e736–43. Doi: 10.1016/S2214-109X(18)30259-6
Borghi C, Tubach F, De Backer G, Dallongeville J, Guallar E, Medina J, et al. Lack of control of hypertension in primary cardiovascular disease prevention in Europe: Results from the EURIKA study. Int J Cardiol. 2016;218:83–8. Doi: 10.1016/j.ijcard.2016.05.044
Burnier M. Antihypertensive Combination Treatment: State of the Art. Curr Hypertens . 2015;17:51. Doi:10.1007/s11906-015-0562-0
Wang YR, Alexander GC, Stafford RS. Outpatient hypertension treatment, treatment intensification, and control in Western Europe and the United States. Arch Intern Med 2007;167:141–7. Doi: 10.1001/archinte.167.2.141
Tarrazo M, Pérez-Ríos M, Santiago-Pérez MI, Malvar A, Suanzes J, Hervada X. Changes in tobacco consumption: boom of roll-your-own cigarettes and emergence of e-cigarettes. Gac Sanit. 2017;31:204–9. Doi: 10.1016/j.gaceta.2016.06.002
Márquez Contreras E, Gil Guillén V, Casado Martínez JJ, Martel Claros N, de la Figuera Von Wichmann M, Martín de Pablos JL, et al. Análisis de los estudios publicados sobre el incumplimiento terapéutico en el tratamiento de la hipertensión arterial en España entre los años 1984 y 2005. Aten Primaria. 2006;38:325–32. Doi:10.1157/13093369
Perseguer-Torregrosa Z, Orozco-Beltrán D, Gil-Guillen VF, Pita-Fernandez S, Carratalá-Munuera C, Pallares-Carratalá V, et al. Magnitude of pharmacological nonadherence in hypertensive patients taking antihypertensive medication from a community pharmacy in Spain. J Manag Care Spec Pharm. 2014;20:1217–25. Doi:10.18553/jmcp.2014.20.12.1217
Abegaz TM, Shehab A, Gebreyohannes EA, Bhagavathula AS, Elnour AA. Nonadherence to antihypertensive drugs. Medicine (Baltimore) 2017;96(4):e5641. Doi: 10.1097/MD.0000000000005641
Peacock E, Krousel-Wood M. Adherence to Antihypertensive Therapy. Med Clin North Am. 2017;101:229–45. Doi: 10.1016/j.mcna.2016.08.005
Alfaro IG. Electronic prescription: limitations and possible improvements to ensure greater adherence to treatments. Rev Esp Salud Pública. 2019;93:e201909070.
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