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Measuring Adherence in Hypertensive Patients-Pilot Study with Self-Efficacy for Appropriate Medication Use Scale in
Zornitsa Mitkova1, Elena Dimitrova2, Velislava Kazakova1
1Department of Organization and Economy of Pharmacy, Faculty of Pharmacy, Medical University Sofia, 1000 Sofia, Bulgaria.
Insights
Hypertension medication adherence in Bulgaria is generally good, but older age, multiple conditions, and numerous prescriptions negatively impact patient compliance. Fixed-dose combinations (FDCs) showed comparable or better adherence than multiple single-drug therapies.
Area of Science:
- Cardiology
- Public Health
- Pharmacology
Background:
- Hypertension is the leading cardiovascular disease in Bulgaria, posing a significant public health challenge.
- Patient non-adherence to medication therapy is a frequent issue in managing hypertension.
- Assessing adherence is crucial for effective hypertension management and improving patient outcomes.
Purpose of the Study:
- To evaluate medication adherence among hypertension patients in Bulgaria.
- To utilize the validated Self-Efficacy for Appropriate Medication Use Scale (SEAMS) for adherence assessment.
- To identify factors influencing medication adherence in the Bulgarian hypertensive population.
Main Methods:
- A cross-sectional study conducted in major cardiology centers in Sofia and Burgas, Bulgaria.
- Data collected from January to July 2024 from 232 hypertension patients.
- Validated Bulgarian version of the SEAMS (19 questions) used, with statistical analyses including Cronbach's α, ANOVA, Pearson correlation, and covariance tests.
Main Results:
- A total of 232 patients (49.6% male, 50.4% female) completed the study.
- Increased number of comorbidities and prescribed medications correlated with lower adherence levels.
- Older age negatively impacted adherence scores; fixed-dose combinations (FDCs) showed similar or better adherence compared to multiple monoproducts across several age groups.
Conclusions:
- Medication adherence among the hypertensive Bulgarian population, as measured by SEAMS, is generally good.
- Factors negatively influencing adherence include older age, polypharmacy, and comorbidities.
- Therapy with monoproducts was associated with poorer adherence compared to FDCs in certain age demographics.
Abstract:
Background and Objectives: Hypertension is found as the leading cardiovascular disease in Bulgaria and the most frequent lifelong condition with a high risk of non-adherence. The aim of this study is to assess the hypertension patients' adherence to medication therapy in Bulgaria by using the self-efficacy for appropriate medication use scale (SEAMS). Materials and Methods: A cross-sectional study was conducted in the major cardiology settings in the capital Sofia and in Burgas, the fourth largest city in Bulgaria. Data were collected from January 2024 to July 2024. The SEAMS was validated in Bulgarian in a sample of patients with hypertension that made it extremely suitable for our study. We applied 19 questions. Additionally, we used Cronbach's α, ANOVA analysis, Pearson correlation, and covariance tests for statistical significance. Results: A total of 232 patients completed the study. Both genders are almost equally distributed (49.6% male and 50.4% female). The results reveal that the increase in the number of diseases and prescribed medicinal products leads to a worsening adherence level. Advancing age negatively affects the adherence scores. The study showed that in half of the age groups studied (patients' age: 40-49, 60-69, and 70-79), adherence in patients treated with FDCs was better or almost the same (patients' age: 50-59) as those treated with several mono-products. Conclusions: Measuring adherence with SEAMS in the hypertensive Bulgarian population in two regions reveals a good level of adherence. Factors negatively affecting adherence were older age, polypharmacy, co-morbidity, and therapy with monoproducts.
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