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What benefit do patients expect from adding second and third antihypertensive drugs?
Hannah Leaman1, Peter R Jackson
1Academic Clinical Pharmacology and Therapeutics Unit, Floor L, Hallamshire Hospital, Sheffield S10 2JF, UK.
British Journal of Clinical Pharmacology
|February 19, 2002
Summary
Patients expect greater benefit from hypertension drugs than provided, with similar expectations for initial and additional treatments. Factors like education and decision-making difficulty influence willingness to take medication.
Area of Science:
- Cardiology
- Public Health
- Health Psychology
Background:
- Hypertension management relies on patient adherence to medication.
- Understanding patient expectations of treatment benefit is crucial for adherence.
Purpose of the Study:
- To determine if patients' expected benefits differ for initial versus additional antihypertensive drugs.
- To identify patient characteristics predicting treatment acceptance.
Main Methods:
- Anonymous questionnaire survey in a primary care setting.
- Randomly sampled patients stratified by age and gender.
- Assessed required Number Needed to Treat for 5 years (NNT5) for myocardial infarction prevention.
Main Results:
- Patients demanded higher benefit (mean NNT5=15.0) for the first drug than typically provided.
- Benefit expectations for additional drugs were similar (NNT5=13.2 for second, NNT5=11.0 for third).
- Gender, decision-making difficulty, and years of education influenced willingness to take treatment.
Conclusions:
- Patient expectations of antihypertensive drug benefit may exceed actual benefits.
- Patients do not perceive starting additional drugs as a lesser step than initiating the first.
- Improving patient understanding of risks and benefits is vital, particularly for those with higher education or who deliberate decisions.