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[Factors associated with medication non-adherence in uncontrolled hypertensive males and females: ODACE study]
G Reach1, D Guedj-Meynier2, B Darné3
1Service d'endocrinologie diabétologie maladies métaboliques, hôpital Avicenne & EA 3412, université Paris 13, Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris, 125, route de Stalingrad, 93000 Bobigny, France.
Insights
Adherence to antihypertensive medication is better in women with uncontrolled hypertension. Lack of motivation and viewing hypertension as a minor issue are key factors contributing to poor adherence in both sexes.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Uncontrolled hypertension affects millions globally, necessitating effective medication adherence.
- Understanding adherence patterns in both males and females is crucial for optimizing treatment outcomes.
Purpose of the Study:
- To quantify medication adherence in male and female patients with uncontrolled hypertension.
- To identify specific factors associated with non-adherence to antihypertensive drugs.
Main Methods:
- General practitioners recruited patients with uncontrolled treated hypertension.
- Adherence was assessed by GPs and via the French League Against High blood pressure (FLAH) questionnaire.
- Logistic regression identified factors linked to non-adherence in males and females separately.
Main Results:
- 1630 males and 1612 females were analyzed.
- Females and GP-estimated adherence showed significantly better results.
- Key factors for non-adherence included lack of motivation, viewing hypertension as non-serious, financial difficulties, and lack of colon cancer screening.
Conclusions:
- Females with uncontrolled hypertension exhibit better treatment adherence.
- Non-adherence is primarily driven by non-clinical factors, with motivation being the most significant.
- Addressing psychological and socioeconomic factors is vital for improving adherence.
Objectives:
The aim of this study was (1) to measure adherence in males and females with uncontrolled hypertension, and (2) to identify factors associated with non-adherence to antihypertensive medication.
Patients And Methods:
Each general practitioner (GP) should include the first two male and the first two female patients with uncontrolled treated hypertension. Adherence to antihypertensive treatment was estimated by the GP and using the French League Against High blood pressure (FLAH) self-administered questionnaire. A stepwise logistic regression analysis was used to identify factors associated with non-adherence on the FLAH scale, independently in males and in females.
Results:
A total of 1630 males and 1612 females were included in the analysis. Adherence to treatment was significantly better in females or when estimated by the GP. Lack of motivation was the first factor associated with poor adherence in both sexes. Considering hypertension as a simple anomaly and not a disease that can lead to cardiac or cerebral disorders was the second common parameter in both sexes. Other common factors were: having monthly periods of financial difficulties in facing his/her needs and absence of regular screening for colon cancer.
Conclusion:
Adherence to treatment is better in uncontrolled hypertensive females. Poor adherence is mainly associated with non-clinical factors. The lack of motivation is the most important element.
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