Factors associated with adherence to antihypertensive agents in the older adult
DOI:
https://doi.org/10.15649/cuidarte.3474Keywords:
Hypertension, Geriatric Nursing, Treatment Adherence and Compliance, AgedAbstract
Highlights
- Controlling arterial hypertension through medication is important to avoid complications related to this disease.
- Identifying the associated factors will help health professionals in promoting treatment success.
- With the practice of health education, it is possible to improve the adherence to pharmacological treatment.
- Make hypertensive patients aware of the importance of medication in the indicated dosage and schedule.
Introduction: With aging, there is an increased risk of suffering from different chronic diseases, including high blood pressure. Hypertension management must be carried out by health professionals, whether or not treatment involves medication. By controlling drug treatment, especially adherence, serious health problems for older people can be avoided. Objective: To determine the factors associated with adherence to arterial hypertension treatment in older adults who live at home. Materials and Methods: A quantitative and cross-sectional study was conducted in La Libertad Region, Peru, with 342 older adults living at home. For data collection, a sociodemographic profile form, anthropometric measurements, blood pressure measurements, the Mini-mental State Examination (MMSE) test, the Geriatric Depression Scale (GDS), and the Morisky Green Levine (MGL) adherence scale were used. In addition, descriptive and analytical statistics were used. Result: 57.60% of the participants did not adhere to the pharmacological treatment, and, in most of the sociodemographic variables examined, they did not adhere to pharmacological treatment in most cases. Likewise, a relationship between retirement in older adults and the MGL adherence scale score was identified. The study showed evidence linking treatment adherence and age (p=0.01), retirement status (p=0.05), and history of stroke (p=0.004). Discussion: Treatment adherence depends on sociodemographic and health factors for disease control and a healthy lifestyle. Conclusion: Older adults and their caregivers need guidance and education to improve adherence to pharmacological treatments.
How to cite this article: Fhon, Jack Roberto Silva; Gómez-Luján, María del Pilar; Caetano, Gideany Maiara; Cáceda-Ñazco, Giovanna Sara; Dos Santos Neto, Alexandre Pereira; Leitón-Espinoza, Zoila Esperanza. Factors associated with adherence to hypertensive pharmacological treatment in the older adult. Revista Cuidarte. 2024;15(1):e3474. https://doi.org/10.15649/cuidarte.3474
References
World Health Organization. Decade of Healthy Ageing 2021-2030. [Internet] 2020 [Cited: October, 12 2023]. Available from: nhttps://www.who.int/initiatives/decade-of-healthy-ageing
Linares-Cánovas LP, Linares-Cánovas LB, Vitón-Castillo AA. Determinación de la adherencia farmacológica en adultos mayores hipertensos. Aten Fam. 2020;28(1):16-20. https://doi.org/10.22201/fm.14058871p.2021.1.77655
Monterrey-Hernández M, Linares-Canovas L, Toledo-del-LLano R, Vazquez-Ramos A, Morales-Monterrey C. Medication adherence and quality of life related to the health condition in hypertensive older adults, Rev cienc med Pinar Río 2021;25(2):e4989 https://revcmpinar.sld.cu/index.php/publicaciones/article/view/4989
Pan American Health Organization. Prevalence of hypertension among adults aged 30-79 years in countries of the Americas. [Internet] 2019 [Cited: October, 15 2023]. Available from: https://www.paho.org/en/enlace/hypertension
González Rodríguez R, Lozano Cordero JG, Aguilar Méndez A, Gómez Domínguez OL, Díaz LM. Caracterización de adultos mayores hipertensos en un área de salud, Rev cuba med gen integr 2017;33(2):199-208. http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21252017000200005
Brown MT, Bussell JK. Medication adherence: who cares? Mayo Clin Proc, 2011; 86(4):304-314. https://doi.org/10.4065/mcp.2010.0575
Martín Alfonso LA, Grau Ábalo JA, Espinosa Brito AD. Conceptual framework for evaluating and improving adherence to medical treatment in chronic diseases. Rev Cubana Salud Pública. 2014;(40)2:225-238. http://scielo.sld.cu/pdf/rcsp/v40n2/spu07214.pdf
Nielsen JØ, Shrestha AD, Neupane D, Kallestrup P. Non-adherence to anti-hypertensive medication in low- and middle-income countries: a systematic review and meta-analysis of 92443 subjects. J Hum Hypertens. 2017;31(1):14-21. https://doi.org/10.1038/jhh.2016.31
Eschenhagen T. Tratamiento de la hipertensión. In: Goodman, Gilman’s. The Pharmacological Basis of Therapeutics. Global Education Holdings. México MX: McGraw-Hill; 2018. p.507-526.
Pan J, Wu L, Wang H, Lei T, Hu B, Xue X, et al. Determinants of hypertension treatment adherence among a Chinese population using the therapeutic adherence scale for hypertensive patients. Medicine (Baltimore), 2019;98(27):e16116. https://doi.org/10.1097/MD.0000000000016116
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens. 2018;36(10):1953-2041. https://doi.org/10.1097/HJH.0000000000001940
Burnier M, Egan BM. Adherence in Hypertension. Circ Res. 2019;124(7):1124-1140. https://doi.org/10.1161/CIRCRESAHA.118.313220
Instituto Nacional de Estadística e Informática. Situación de salud de la Población Adulta mayor. 2016. Consulta: Septiembre 14, 2023. Disponible en: https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1459/libro.pdf
Fhon JRS, Gómez-Luján MP, Caetano GM, Cáceda Nazco GS, Dos Santos NAP, Leitón-Espinoza ZE. Factors associated with adherence to hypertensive pharmacological treatment in the older adult. Mendeley Data V1. 2024 doi: https://doi.org/10.17632/djk9bwjvkf.1
Kish L. A procedure for objective respondent selection within the household. Journal of the American Statistical Association. 1949;44(247):380-87. https://doi.org/10.1080/01621459.1949.10483314
Center for disease control and prevention. How to measure height and weight accurately at home. [Internet] 2017 [Cited: 2023 Oct 15]. Available from: nhttps://www.cdc.gov/healthyweight/spanish/assessing/bmi/childrens_bmi/como_medir_ninos_adolescentes.html
Ministerio de salud. Guía Técnica para la Valoración Nutricional Antropométrica de la Persona Adulta. Instituto Nacional de salud del Perú. 2012. Consulta: Septiembre 22, 2023. Disponible en: https://alimentacionsaludable.ins.gob.pe/sites/default/files/2017-02/GuiaAntropometricaAdulto.pdf
Serra RJA, Cuesta TF. Valoración geriátrica integral. In: García LMA, Ruipérez CI. Valoración nutricional en el anciano: recomendaciones prácticas de los expertos en geriatría y nutrición. 2007, p. 41-61. https://www.segg.es/media/descargas/Acreditacion%20de%20Calidad%20SEGG/Residencias/valoracion_nutricional_anciano.pdf
World Health Organization. Manual de vigilancia STEPS de la OMS: el método STEPwise de la OMS para la vigilancia de los factores de riesgo de las enfermedades crónicas, 2006. Consulta: Octubre 8, 2023. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/43580/9789244593838_spa.pdf?sequence=1&isAllowed=y
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206-52. https://doi.org/10.1161/01.HYP.0000107251.49515.c2
Laguna JY, Arbeloa GL. Manual de Descripción de los Grupos Relacionados por el Diagnóstico. (AP-GRD v 25.0), 2010. https://www.osakidetza.euskadi.eus/contenidos/informacion/osk_publicaciones/es_publi/adjuntos/calidad/ManualAPGRDv.25.0.pdf
Icaza MG, Albala C. Minimental State Examinations (MMSE) del estudio de la demencia en Chile: Análisis Estadístico. Serie Investigaciones en Salud Pública. 1999. https://pt.scribd.com/document/526069118/Minimental-State-Examinations-Del-Estudio-de-Demencia-en-Chil-Icaza-Albala-1999
Guigoz Y, Vellas B, Garry PJ. Mini Nutritional Assessment: A practical Assessment Tool for Grading the Nutritional State of Elderly Patients. In: Vellas B, Ed., The Mini Nutritional Assessment (MNA), Supplement No 2, Serdi Publisher; 2004. p.15-59.
Morisky DE, Green LW, Levine DM. Validez concurrente y predictiva de una medida autoinformada de adherencia a la medicación. Med Care 1986;24(1):67-74. https://doi.org/10.1097/00005650-198601000-00007
Ortega L. Uso de los Cuestionarios para medir la Adherencia al tratamiento Antirretroviral, 2004. Consulta: Septiembre 25, 2023. Disponible en: https://www.sefh.es/bibliotecavirtual/3_AF_VIH_2003/8_cuestionarios_medir_adherencia.pdf
Hoyl T, Valenzuela E, Marín PP. Depresión en el adulto mayor: evaluación preliminar de la efectividad, como instrumento de tamizaje, de la versión de 5 ítems de la Escala de Depresión Geriátrica. Rev. méd. Chile. 2000;128(11):1199-1204. http://dx.doi.org/10.4067/S0034-98872000001100003
Berlowitz DR, Foy CG, Kazis LE, Bolin LP, Conroy MB, Fizpatrick P, Gure TR. et al. Effect of intensive blood-pressure treatment on patient-reported outcomes. N. Engl. J. Med. 2017;377(8):733-744. https://doi.org/10.1056/NEJMoa1611179
Khayyat SM, Khayyat SMS, Hyat ARS, Mohamed MMA, Abdul HM. Predictors of medication adherence and blood pressure control among Saudi hypertensive patients attending primary care clinics: a cross-sectional study. PLoS One. 2017;12(1):e0171255. https://doi.org/10.1371/journal.pone.0171255
Khayyat SM, Khayyat SMS, Hyat ARS, Mohamed MMA, Abdul HM. Predictors of medication adherence and blood pressure control among Saudi hypertensive patients attending primary care clinics: a cross-sectional study. PLoS One. 2017;12(1):e0171255. https://doi.org/10.1371/journal.pone.0171255
Uchmanowicz B, Jankowska EA, Uchmanowicz I, Morisky DE. Self-reported medication adherence measured with morisky medication adherence scales and its determinants in hypertensive patients aged ≥60 years: A systematic review and meta-analysis. Front pharmacol, 2019;10:168. http://dx.doi.org/10.3389/fphar.2019.00168
Wang W, Luan W, Zhang Z, Mei Y. Association between medication literacy and medication adherence and the mediating effect of self-efficacy in older people with multimorbidity. BMC geriatrics. 2023;23(1):378. https://doi.org/10.1186/s12877-023-04072-0
Xue J, Conwell Y, Tang W, Bogner HR, Li Y, Jiang Y, et al. Treatment adherence as a mediator of blood pressure control in Chinese older adults with depression. Int J Geriatr Psychiatry. 2019;34(3):432-438. https://doi.org/10.1002/gps.5032
Shi S, Shen Z, Duan Y, Ding S, Zhong Z. Association between medication literacy and medication adherence among patients with hypertension. Front Pharmacol. 2019;10:822. https://doi.org/10.3389/fphar.2019.00822
Yang C, Hui Z, Zeng D, Zhu S, Wang X, Lee DTF et al. A community-based nurse-led medication self-management intervention in the improvement of medication adherence in older patients with multimorbidity: protocol for a randomized controlled trial. BMC Geriatr, 2021;21(1):152. https://doi.org/10.1186/s12877-021-02097-x
Burgal-Cintra CJ, Pérez-Bichor A, Ortega-López IL. Caracterización de la adherencia terapéutica en adultos mayores hipertensos. Rev Méd Electrón 2021;43(6):1606-1616. https://revmedicaelectronica.sld.cu/index.php/rme/article/view/4435/pdf
Gewehr DM, Bandeira VAC, Gelatti GT, Colet CF, Oliveira KR. Adherence to pharmacological treatment of arterial hypertension in Primary Health Care. Saúde debate, 2018;42(116):179-190.https://doi.org/10.1590/0103-1104201811614
Kang CD, Tsang PPM, Li WTL, Wang HHX, Liu KQL, Griffiths SM, et al. Determinants of medication adherence and blood pressure control among hypertensive patients in Hong Kong: a cross-sectional study. Int. J. Cardiol. 2015;182:250-257. https://doi.org/10.1016/j.ijcard.2014.12.064
Li YT, Wang HHX, Liu KQL, Lee GKY, Chan WM, Griffiths SM, et al. Medication adherence and blood pressure control among hypertensive patients with coexisting long-term conditions in primary care settings: a cross-sectional analysis. Medicine (Baltimore). 2016;95(20):e3572.https://doi.org/10.1097/MD.0000000000003572
Guimarães MCLP, Coelho JC, Santos J, Higa CBO, Florido CF, Lee RJW, et al. Adherence to antihypertensive treatment during the COVID-19 pandemic: findings from a cross-sectional study. Clin Hypertens. 2022;28(1):35. https://doi.org/10.1186/s40885-022-00219-0
Ramos Morales LE. La adherencia al tratamiento en las enfermedades crónicas. Revista Cubana de Angiología y Cirugía Vascular. 2015;16(2):175-189. https://www.medigraphic.com/pdfs/revcubangcirvas/cac-2015/cac152f.pdf
Heiby EM, Carlson JG. The health compliance model. JCHC, 1986;1(2):135-152. https://europepmc.org/article/med/10301291
Heiby EM, Lukens CL, Frank MR. The Health Compliance Model II. The Behavior Analyst Today 2005;6(1):27-42. https://doi.org/10.1037/h0100050
Weinstein ND, Lyon JE, Sandman PM, Cuite CL. Experimental evidence for stages of health behavior change: the precaution adoption process model applied to home radon testing. Health psychol. 1998;17(5):445–453. https://doi.org/10.1037//0278-6133.17.5.445
xHypertension. Antihypertensive medication adherence and the risk of vascular events and falls after stroke: a real-world effectiveness study using linked registry data. Hypertension. 2023;80(1):182-191. https://doi.org/10.1161/HYPERTENSIONAHA.122.19883
Gynnild MN, Aakerøy R, Spigset O, Askim T, Beyer MK, Ihle-Hansen H, et al. Vascular risk factor control and adherence to secondary preventive medication after ischemic stroke. J Intern Med. 2021;289(3):355-368. https://doi.org/10.1111/joim.13161
Lima DBS, Moreira TMM, Borges JXP, Rodrigues MTP. Association between treatment compliance and different types of cardiovascular complications in arterial hypertension. Texto y Contexto Enfermagem. 2016;25(3):e0560015. https://doi.org/10.1590/0104-07072016000560015
Shi Y, Yang D, Zeng Y, Wu W. Risk factors for post-stroke depression: a meta-analysis. Front. Aging Neurosci. 2017;9:218. https://doi.org/10.3389/fnagi.2017.00218
Arowoiya AI, Elloker T, Karachi F, Mlenzana N, Khuabi LJ, Rhoda A. Using the World Health Organization's disability assessment schedule (2) to assess disability in community-dwelling stroke patients. Afr. J. Physiother, 2017;73(1):343. https://doi.org/10.4102/sajp.v73i1.343
Sakr F, Dabbous M, Akel M, Salameh P, Hosseini H. Adherence to post-stroke pharmacotherapy: scale validation and correlates among a sample of stroke survivors. Medicina (Kaunas), 2022;58(8):1109. https://doi.org/10.3390/medicina58081109
Marseille BR, Commodore-Mensah Y, Davidson PM, Baker D, D’Aoust R, Baptiste DL. Improving hypertension knowledge, medication adherence, and blood pressure control: a feasibility study. J Clin Nur, 2021;30(19-20):2960-2967. https://doi.org/10.1111/jocn.15803
Kes D, Polat U. The effect of nurse‐led telephone support on adherence to blood pressure control and drug treatment in individuals with primary hypertension: A randomized controlled study. Int J Nurs Pract, 2022;28(3):e12995. https://doi.org/10.1111/ijn.12995
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