1887
Volume 2006, Issue 1
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

ملخص

Introduction: In the absence of objective evidence, doc-tors frequently overestimate the level of their patient's ad-herence to medication and there is no published work look-ing at what factors influence the doctor's perceptions of medication adherence by hypertensive patients. Therefore, the aim of this study to determine the doctor's perceptions of adherence to antihypertensive medication and to com-pare this with their perceptions of the clinical situation and with the patient's self -reported medication adherence.

Methods: An English self reporting measure (7-item questionnaire) was adapted and translated to Arabic and used to determine the adherence to hypertensive medica-tion. Also, a 10-item questionnaire was developed to elicit the doctor's perception of adherence (taking > 80% of doses) and the treatment and overall condition. This de-scriptive study was conducted in across 2 primary health centers in Abu-Dhabi, UAE.

Results: About 40 % of them were controlled regard-ing BP and 30% of hypertensive patients were diabetics. The doctors estimated adherence to be high (taking more than 80% of doses) in 143 (71%) of patients compared with 103(52%) patients who reported high adherence by using Morisky score where, there was a statistically significant relationship between them. Of the 143 subjects perceived by their doctors as having high adherence, only 64 (45%) succeeded to achieve the target blood pressure (p <  0.001) while 55 (52%) of the adherent patients from the self-reported point of view achieved their target BP (p <  0.001). The doctor evaluation was not as good as expected for treatment effectiveness and quality of communication (57% only were evaluated as good). Only the doctor's evaluation of the seriousness of the medical situation showed a sig-nificant correlation with the self-reported adherence and this was in the opposite direction (gamma = - 0.32, p < 0.05). 71% of the adherent patients perceived by doctors were estimated to have effective treatment (p <  0.0001) while 81% of patients achieved their target BP were estimated to have effective treatment by their doctors.

Conclusion: The practical assessment of adherence and drug management would have been greatly enhanced if the results of the Arabic/English self-reporting measure had been available to the doctors in the course of routine practice.

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References

  1. Mushlin Al, Appel FA. Diagnosing potentialnoncompliance. Physicians' ability in a behavioral dimension of medical care. Arch Int Med. 1997; 137:3:318321.
    [Google الباحث العلمي]
  2. Gilbert JR, Evans CE, Haynes RB, Tugwell P. Predicting compliance with a regimen of digoxin therapy in family practice. Can Med Assoc J. 1980; 123:2:199122.
    [Google الباحث العلمي]
  3. Goldberg Al, Cohen G, Rubin AH. Physician assessments of patient compliance with medical treatment. Soc Sci Med. 1998; 47:11:18731876.
    [Google الباحث العلمي]
  4. Feierabend RH. Physician ability to predict appointment-keeping behavior of prenatal patients. J Fam Pract. 1996; 42:5:482486.
    [Google الباحث العلمي]
  5. Kjellgren KI, Ahlner J, Dahlof B, Gill H, Hedner T, Saljo R. patients' and physicians' assessment of risks associated with hypertension and benefits from treatment. J Cardiovasc Risk. 1998; 5:3:161166.
    [Google الباحث العلمي]
  6. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986; 24:1:6774.
    [Google الباحث العلمي]
  7. Gao X, Nau DP. Congruence of three self-repot measures of medication adherence among HIV patients. Ann Pharmacother. 2000; 34:10:11171122.
    [Google الباحث العلمي]
  8. Pratt RJ, Robinson N, Loveday HP, Pellowe CM, Franks PJ, Hankins M. adherence to antiviral therapy: appropriate use of self-reporting in clinical practice. HIV Clinical Trials. 2001; 2:2:146159.
    [Google الباحث العلمي]
  9. Patel R, Taylor S. factors affecting medication adherence in hypertensive patients. Ann Pharmacother. 2002; 36::4045.
    [Google الباحث العلمي]
  10. Pineiro CF, Gil GVF, Donis OM, Orozco BD, Pastor LR, Merino SJ. Validity of 6 indirect methods in the evaluation of compliance to drug treatment of non-insulin dependent diabetes mellitus. Rev Clin Esp. 1997; 197:8:555559.
    [Google الباحث العلمي]
  11. Pineiro CF, Gil GVF, Donis OM, Orozco BD, Pastor LR, Merino SJ. The validity of 6 indirect methods for assessing drug treatment compliance in arterial hypertension. Aten Primaria. 1997; 19:7:372374, 376.
    [Google الباحث العلمي]
  12. George CF, Peveler RC, Heilger S, Thompson C. Compliance with tricyclic antidepreeants: the value of four different methods of assessment. Br J clin Pharmacol. 2000; 50:2:166171.
    [Google الباحث العلمي]
  13. Ward HJ, Morisky DE, Lees NB, Frong R. A clinic and community-based approach to hypertension control for an underserved minority population: design and methods. Am J Hypertens. 2000; 13:2:177183.
    [Google الباحث العلمي]
  14. Beevers G, Lip GY, 0_Brien E. ABC of hypertension: Blood pressure measurement, part II-conventional sphegmomano-metry: technique of auscultatory blood pressure measurement. BMJ (Clinical Research Ed). 2001; 322:7293:10431047.
    [Google الباحث العلمي]
  15. British Hypertension Society, Blood Pressure Measurement-Recommendations of the British Hypertension Society, 3rd Ed, 1997.
  16.   Joint National Committee on Prevention, Detection, Evalua-tion and Treatment of High Blood Pressure. Archives of Internal Medicine. 1997; 157::24132446.
    [Google الباحث العلمي]
  17. Horne R, Weinman J. Patients' beliefs about prescribed medi-cines and their role in adherence to treatment in chronic physical illness. J Psychosom res. 1999; 47:6:555567.
    [Google الباحث العلمي]
  18. Meyer D, Leventhal H, Gutmann M. Common-sense models of illness: the example of hypertension. Health Psychol. 1985; 4:2:115135.
    [Google الباحث العلمي]
  19. Guo H, He H, Jiang J. Study on the compliance of anyihyper-tensive drugs in patients with hypertension. Zhonghua Liu Xing Bing Xue Za Zhi. 2001; 22:6:418420.
    [Google الباحث العلمي]
  20. Enlund H, Jokisalo E, Wallenius S, Korhonen M. Patient-perceived problems, compliance, and the outcome of hyperten-sion treatment. Pharm World Sci. 2001; 23:2:6064.
    [Google الباحث العلمي]
  21. Svensson S, Kjellgren KI, Ahlner J, Saljo R. Reasons for adherence with antihypertensive medication. Int J Cardiol. 2000; 76:2-3:157163.
    [Google الباحث العلمي]
  22. Kjellgren KI, Svensson S, Anhler J, Saljo R. Antihypertensive medication in clinical encounters. Int J Cardiol. 1998; 64:2:161169.
    [Google الباحث العلمي]
  23. Wilson P, D'Agostino R, Levy D, Belanger A, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998; 97::18371847.
    [Google الباحث العلمي]
  24. Thunstall- Pedoe H. The Dundee Coronary Risk-disk for mana-gement of change in risk factors. NBMJ. 1991; 303::744747.
    [Google الباحث العلمي]
  25. Hag I, Ramsay L, Yeo WW, Jackson P, Wallis E. Is the Framingham risk function valid for northern European populations? A comparison of methods for estimating absolute coronary risk in high risk men. Heart. 1999; 83::4046.
    [Google الباحث العلمي]
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