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[Identification of non-compliant hypertensive patients]
Marianne Agergaard1, Marianne Maibøll, Pernille Dam
1Pharmakon, Apotekernes Uddannelsescenter, Milnersvej 42, 3400 Hillerød, Denmark. mag@pharmakon.dk
Insights
A validated instrument helps identify patients with hypertension who struggle with medication adherence. This tool aids healthcare providers in recognizing and addressing poor compliance among hypertensive patients.
Area of Science:
- Pharmacology and Health Services Research.
- Focuses on medication adherence and patient compliance in hypertension management.
Context:
- Hypertension management in primary care requires tools to identify patients with poor medication compliance.
- Existing methods may not adequately capture the nuances of non-compliance.
Purpose:
- To develop and validate an instrument for identifying patients with poor adherence to hypertension medication in primary healthcare settings.
- To contribute to improved patient outcomes through better medication management.
Summary:
- A study analyzed data from 1,421 hypertensive patients using questionnaires, the Danish "Patient Medical Profile" (PEM), and electronic medicine containers (MEMS).
- Key findings indicate "Unintentional non-compliance" is central, relating to "Intentional non-compliance" and "Medical concern," and correlates with PEM.
- Systolic blood pressure emerged as a crucial variable due to its correlation with both PEM and MEMS, highlighting its importance in compliance assessment.
Impact:
- The developed and validated instrument can effectively identify hypertensive patients with poor compliance in primary care.
- Facilitates targeted interventions to improve medication adherence and potentially blood pressure control.
Introduction:
The purpose was to contribute to the development of a validated instrument for identification of patients with poor compliance in the use of hypertension medicine in primary health care.
Material And Methods:
The analysis included questionnaire data from 1,421 hypertensive patients, data from the Danish register "Patient Medical Profile" (PEM, n = 182) and electronic medicine containers (MEMS, n = 33). The analysis included preliminary scale validation resulting in five scales. The scales were used in a subsequent multivariate regression analysis which involved a total of 29 variables. The key variables were established via the correlations between variables in the graphic model and included in the instrument.
Results:
The scale "Unintentional non-compliance" (concerning the patient's self-assessed tendency to forget to take the medicine) is central in the graphic network in terms of its relation to the scales "Intentional non-compliance" (when patients opt not to follow the prescriptions) and "Medical concern" (concerns related to medicine intake). "Unintentional non-compliance", moreover, correlates with PEM. The item concerning the patient's systolic blood pressure proved to be crucial because of its correlation with both PEM and MEMS. The scales "Medical concern" and "Intentional non-compliance" are, moreover, assessed to measure different dimensions of compliance.
Conclusion:
A group of items has been developed and validated. Collectively they can identify hypertensive patients with poor compliance in primary health care.
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