Prevalence of non-adherence to antihypertensive medication in a sample from the city of Juiz de Fora – MG

Authors

DOI:

https://doi.org/10.34019/1982-8047.2021.v47.32607

Keywords:

Hypertension, Drug therapy, Antihypertensive Agents

Abstract

Introduction: Systemic Arterial Hypertension (SAH) in Brazil is prevalent in 23.9% of individuals aged 18 years or older. International studies indicate that adherence is prevalent in approximately 50% of patients with SAH, while in Brazil, adherence rates vary between 23% and 62.1%. The great damage to patients and the extensive public health expenditures on the treatment of their complications make the topic of paramount importance. Objective: To determine the main causes of non-adherence to drug treatment for SAH. Material and Methods: A descriptive, cross-sectional, quantitative study, developed with 396 patients with SAH, selected from primary health care (PHC) centers and from the service for hypertensive individuals in the city of Juiz de Fora: Serviço de Controle de Hipertensão, Diabetes e Obesidade (SCHDO). Data collection took place between October 2018 and January 2019, making use of the Morisky-Green Test and questions added by the researchers to enhance the interpretation of the results. Results: It was observed that 279 (70.5%) of the interviewees are non-adherent to the treatment and great part of them have been at least once careless concerning the right time to take their pills (51%). In the multivariate analysis, it is clear that race is a significant variable to influence adherence to therapy (OR = 1.683; CI 1.072-2.643; p = 0.024); the percentage of white, brown and black non-adherent individuals are 40.5%, 29.4 and 30.1%, respectively; 29.5% of respondents known to be correct in their treatment. Conclusions: The main modifiable causes that result in low adherence are related to forgetfulness and carelessness. The absence of adherence is not related to the price of the medication.

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References

Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M et al. Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens. 2018; 36(10):1953-2041. doi: 10.1097/HJH.0000000000001940.

NCD Risk Factor Collaboration. Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants. Lancet. 2017; 389(10064):37-55. doi: 10.1016/S0140-6736(16)31919-5. Epub 2016 Nov 16.

Chow CK, Teo KK, Rangarajan S, Islam S, Gupta R, Avezum A et al. PURE (Prospective Urban Rural Epidemiology) Study investigators: Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA. 2013; 310(9):959-68. doi: 10.1001/jama.2013.184182. PMID: 24002282.

Leiva A, Aguiló A, Fajó-Pascual M, Moreno L, Martín MC et al. Efficacy of a brief multifactorial adherence-based intervention in reducing blood pressure: a randomized clinical trial. Patient Prefer Adherence. 2014 ; 8:1683-90. doi: 10.2147/PPA.S66927. PMID: 25525344; PMCID: PMC4266385.

Barroso WKS, Rodrigues CIS, Bortolotto LA, Mota-Gomes MA, Brandão AA, Feitosa ADM et al. Diretrizes Brasileiras de Hipertensão Arterial: 2020. 2020. doi: 10.36660/abc.20201238

Instituto Brasileiro de Geografia e Estatística (BR). Pesquisa nacional de saúde 2019: percepção do estado de saúde, estilos de vida, doenças crônicas e saúde bucal. Rio de Janeiro: IBGE; 2020.

Ettehad D, Emdin CA, Kiran A, Anderson SG, Callender T, Emberson J et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. 2016; 387(10022):957-967. doi: 10.1016/S0140-6736(15)01225-8. Epub 2015 Dec 24. PMID: 26724178.

Yang Q, Chang A, Ritchey MD, Loustalot F. Antihypertensive medication adherence and risk of cardiovascular disease among older adults: a population-based cohort study. J Am Heart Assoc. 2017; 6(6):e006056. doi: 10.1161/JAHA.117.006056. PMID: 28647688; PMCID: PMC5669200.

World Health Organization. Adherence to long-term therapies: evidence for action. World Health Organization; 2003.

Malachias MVB, Rodrigues CIS, Muxfeldt E, Salles GF, Moreno Júnior H, Gus M. Diretriz Brasileira de Hipertensão Arterial: hipertensão arterial resistente. Arq Bras Cardiol. 2016; 107(3):75-8. doi : 10.5935/abc.20160163

Pereira PM, Landim KSD, Martins DP, Chimello M de F, Santos JLS, Kutz NA et al. Estilo de vida, adhesión medicamentosa y no medicamentosa en pacientes hipertensos: una revisión. EFDeportes. 2020 ; 25(268):112-26. doi: 10.46642/efd.v25i268.2271

Roldan PC, Ho GY, Ho PM. Updates to adherence to hypertension medications. Curr Hypertens Rep. 2018; 20(4):34. doi: 10.1007/s11906-018-0830-x. PMID: 29637312.

Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005 ; 353(5):487-97. doi: 10.1056/NEJMra050100. PMID: 16079372.

Weisser B, Predel HG, Gillessen A, Hacke C, Vor dem Esche J, Rippin G et al. single pill regimen leads to better adherence and clinical outcome in daily practice in patients suffering from hypertension and/or dyslipidemia: results of a meta-analysis. High Blood Press Cardiovasc Prev. 2020; 27(2):157-64. doi: 10.1007/s40292-020-00370-5. Epub 2020 Mar 26. PMID: 32219670; PMCID: PMC7160084.

Lu CH, Tang ST, Lei YX, Zhang MQ, Lin WQ, Ding SH et al. Community-based interventions in hypertensive patients: a comparison of three health education strategies. BMC Public Health. 2015; 15:33. doi: 10.1186/s12889-015-1401-6. PMID: 25631224; PMCID: PMC4314804.

Carter BL, Coffey CS, Ardery G, Uribe L, Ecklund D, James P et al. Cluster-randomized trial of a physician/pharmacist collaborative model to improve blood pressure control. Circ Cardiovasc Qual Outcomes. 2015; 8(3):235-43. doi: 10.1161/CIRCOUTCOMES.114.001283. Epub 2015 Mar 24. PMID: 25805647; PMCID: PMC4618490.

Ben Angela Jornada, Neumann Cristina Rolim, Mengue Sotero Serrate. Teste de Morisky-Green e Brief Medication Questionnaire para avaliar adesão a medicamentos. Rev Saúde Pública. 2012; 46(2):279-89. doi: 10.1590/S0034-89102012005000013.

Almeida RN, Rosa MM, Nauman GA, da Silva VE, Sousa Moreira A, Silva ML et al. A utilização do teste Morisky-Green na adesão ao tratamento anti-hipertensivo: detecção precoce na atenção primária à saúde. Revista Arquivos Científicos (IMMES). 2020; 3(1):132-41. https://doi.org/10.5935/2595-4407/rac.immes.v3n1p132-141

Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986; 24(1):67-74. doi: 10.1097/00005650-198601000-00007. PMID: 3945130.

Delgado AB, Lima ML. Contributo para a validação concorrente de uma medida de adesão aos tratamentos. Psic Saúde Doenças. 2001; 2(2):81-100.

Pucci N, Pereira MR, Vinholes DB, Pucci P, Campos ND. Conhecimento sobre hipertensão arterial sistêmica e adesão ao tratamento anti-hipertensivo em idosos. Rev Bras Cardiol. 2012; 25(4):322-9.

Eid LP, Nogueira MS, Veiga EV, Cesarino EJ, Alves LMM. Adesão ao tratamento anti-hipertensivo: análise pelo Teste de Morisky-Green. Rev. Eletr. Enferm. 2013; 15(2):362-7. doi: https://doi.org/10.5216/ree.v15i2.15599.

Strelec MAAM, PAMG, Mion Jr. D. The influence of patient's consciousness regarding high blood pressure and patient's attitude in face of disease controlling medicine intake. Arq Bras Cardiol. 2003; 81(4):349-54. doi: 10.1590/S0066-782X2003001200002.

SARTORI AC. Mhealth no sistema hiperdia: estratégia alternativa para intensificação da adesão à terapia do diabetes e da hipertensão. [Dissertação]. Maringá: Centro Universitário de Maringá; 2019.

Dantas, RTSDO. Instrumentos para mensurar a adesão à farmacoterapia–uma revisão integrativa [dissertação]. Campina Grande: Universidade Federal de Campina Grande; 2020.

Tavares NUL, Bertoldi AD, Mengue SS, Arrais PSD, Luiza VL, Oliveira MA et al. Fatores associados à baixa adesão ao tratamento farmacológico de doenças crônicas no Brasil. Rev Saúde Pública. 2016; 50(Suppl 2):10s. doi: 10.1590/s1518-8787.2016050006150.

Barbosa MEM, Bertelli EVM, Aggio CDM, Scolari GADS, Marcon SS, Carreira L. Fatores associados à adesão de adultos/idosos ao tratamento da hipertensão arterial na atenção. Revista Enfermagem UERJ. 2019; 27:45894.

Barreto MS, Matsuda LM, Marcon SS. Fatores associados ao inadequado controle pressórico em pacientes da atenção primária. Esc Anna Nery. 2016; 20(1):114-20. doi: 10.5935/1414-8145.20160016.

Gewehr DM, Bandeira VAC, Gelatti GT, Colet CF, Oliveira KR. Adesão ao tratamento farmacológico da hipertensão arterial na atenção primária à saúde. Saúde debate. 2018; 42(116):179-90. doi: 10.1590/0103-1104201811614.

Sawyer DO, Leite IC, Alexandrino R. Perfis de utilização de serviços de saúde no Brasil. Ciênc Saúde Coletiva. 2002; 7(4):757-76. doi: 10.1590/S1413-81232002000400012.

Aquino GA, Cruz DT, Silvério MS, Vieira MT, Bastos RR, Leite ICG. Fatores associados à adesão ao tratamento farmacológico em idosos que utilizam medicamento anti-hipertensivo. Rev Bras Geriatr Gerontol. 2017; 20(1):111-22. doi: 10.1590/1981-22562017020.160098.

Instituto Brasileiro de Geografia e Estatística (BR). Pesquisa Nacional de Saúde 2019: informações sobre domicílios, acesso e utilização dos serviços de saúde. Rio de Janeiro: IBGE; 2020.

Motter FR, Olinto MTA, Paniz VMV. Conhecimento sobre a farmacoterapia por portadores de hipertensão arterial sistêmica. Ciênc Saúde Coletiva. 2013; 18(8):2263-74. doi: 10.1590/S1413-81232013000800010.

Corrao G, Parodi A, Zambon A, Heiman F, Filippi A, Cricelli C et al. Reduced discontinuation of antihypertensive treatment by two-drug combination as first step. Evidence from daily life practice. 2010; 28(7). doi: 10.1097/HJH.0b013e328339f9fa

Dhar L, Earnest J, Ali M. A systematic review of factors influencing medication adherence to hypertension treatment in developing countries. Open Journal of Epidemiology. 2017 ; 7(3):211-50. doi: 10.4236/ojepi.2017.73018.

Rabelo LM, Alexandre KV, Celestino MS, Cangirana JF, Albuquerque LKA, Soares SMLP et al. O papel educativo do enfermeiro na adesão ao tratamento da hipertensão arterial sistêmica: revisão integrativa da literatura. Mundo Saúde. 2014; 4(38):473-81. doi: 10.6084/m9.figshare.11874123.

Pinhati R, Ferreira R, Carminatti M, Colugnati F, Paula R, Sanders, Pinheiro H. Adherence to antihypertensive medication after referral to secondary healthcare: a prospective cohort study. International Journal of Clinical Practice. 2020; 28:e13801. doi: 10.1111/ijcp.13801

Moura BV, Lopes GS. Orientação farmacêutica de idosos com hipertensão arterial: relação com a adesão e conhecimento da doença. Almanaque Multidisciplinar de Pesquisa. 2019; 1(2):63-78.

Published

2021-04-19

How to Cite

1.
Chehuen Neto JA, Erothildes Ferreira R, Barbosa Ázar AL, Oliveira Duarte JH, de Paula Souza JP, De Almeida LA. Prevalence of non-adherence to antihypertensive medication in a sample from the city of Juiz de Fora – MG . HU Rev [Internet]. 2021Apr.19 [cited 2024Nov.22];47:1-9. Available from: https://periodicos.ufjf.br/index.php/hurevista/article/view/32607

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