PP.30.41: NONADHERENCE TO ANTIHYPERTENSIVE TREATMENT IN PRIMARY CARE. (June 2015)

• Record Type: Journal Article
• Authors: Ardeleanu, E.; Lighezan, D.; Lighezan, R.; Deleanu, A.; Gurgus, D.; Popovici, M.; Nicola, P.; Baaj, S.
• Is Part Of: Journal of hypertension. Volume 33(2015)Supplement 1
• Publication Date: 2015-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000468665.06494.6f
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: The aim of the study was to assess the prevalence of nonadherence to antihypertensive treatment, the analysis of factors correlated to nonadherence and to implement measures for a better compliance in primary care. Design and method: From 2010 to 2014 we evaluated clinical, by laboratory and questionnaires a number of 3145 hypertensive over 18 years from 19 family medicine offices of Timis County, who had at least 2 visits during the last year at the general practitioner. Results: After one year of monitorization, from 1102 uncontrolled hypertensive a number of 584 (52.99%) demonstrated to be nonadherent to treatment. The comparison between the characteristics of nonadherent vs. adherent hypertensive showed no difference regarding age (58 ± 11.8 vs. 62.4 ± 12.4) or gender. We noticed a higher nonadherence in the age groups under 40 and over 75 years, but without statistical significance. In nonadherents smoking was present in 24.1% vs. 17.2%, dyslipidemia in 40% vs. 36%, a BMI > 30 kg/m2 in 46.23% vs. 34.9%, organ damage in 19% vs. 26.72% and cardiovascular disease in 16.6% vs. 20.9% (p < 0.05 for all comparisons). SBP/DBP was higher in nonadherent (164/92 mmHg vs. 141/79 mmHg) (p < 0.05). The majority of cases, respectively 74.14% of nonadherent had a high cardiovascular risk, an intermediate risk was present in 18.49% and a low risk in 7.36%. Lifestyle factors associated with nonadherence were obesity in 46.06%, physical inactivity in 45.03%, an excessive alcohol consumption in 42.12% and salt consumption in 42.12%. Conclusions: Nonadherence was associated with a poor socioeconomic and educational level and limited information about the disease, treatment and low confidence in the medical team. Nonadherence was connected with factors as smoking, excessive alcohol consumption, obesity, physical inactivity, administration of a multiple medication and the appearance of secondary effects of the drugs. The medical team of the general practitioner improved by educational actions the adherence to antihypertensive treatment.