Medication Adherence and Blood Pressure Control Among Hypertensive Patients With Coexisting Long-Term Conditions in Primary Care Settings

2.50
Hdl Handle:
http://hdl.handle.net/2436/617328
Title:
Medication Adherence and Blood Pressure Control Among Hypertensive Patients With Coexisting Long-Term Conditions in Primary Care Settings
Authors:
Li, Yu Ting; Wang, Harry H.X.; Liu, Kirin Q.L.; Lee, Gabrielle K.Y.; Chan, Wai Man; Griffiths, Sian M.; Chen, Ruoling
Abstract:
Hypertension is a typical example of long-term disease posing formidable challenges to health care. One goal of antihypertensive therapy is to achieve optimal blood pressure (BP) control and reduce co-occurring chronic conditions (multimorbidity). This study aimed to assess the influence of multimorbidity on medication adherence, and to explore the association between poor BP control and multimorbidity, with implications for hypertension management. A cross-sectional design with multistage sampling was adopted to recruit Chinese hypertensive patients attending general out-patient clinics from 3 geographic regions in Hong Kong. A modified systemic sampling methodology with 1 patient as a sampling unit was used to recruit consecutive samples in each general out-patient clinic. Data were collected by face-to-face interviews using a standardized protocol. Poor BP control was defined as having systolic BP/diastolic BP 130/80mm Hg for those with diabetes or chronic kidney disease; and 140/90mmHg for others.Medication adherencewas assessed by a validatedChinese version of the Morisky Medication Adherence Scale. A simple unweighted enumeration was adopted to measure the combinations of coexisting long-term conditions. Binary logistic regression analysis was conducted with medication adherence and multimorbidity as outcome variables, respectively, after controlling for effects of patient-level covariates. The prevalence of multimorbidity was 47.4% (95% confidence interval [CI] 45.4%–49.4%) among a total of 2445 hypertensive patients. The proportion of subjects having 0, 1, and 2 additional long-term conditions was 52.6%, 29.1%, and 18.3%, respectively. The overall rate of poor adherence to medication was 46.6%, whereas the rate of suboptimal BP control was 48.7%. Albeit the influence of multimorbidity on medication adherence was not found to be statistically significant, patients with poorly controlled BP were more likely to have multimorbidity (adjusted odds ratio 2.07, 95% CI 1.70–2.53, P<0.001). Diabetes was the most prevalent concomitant long-term condition among hypertensive patients with poor BP control (38.6%, 95% CI 35.8–41.4 vs 19.7%, 95% CI 17.5–21.9 for patients with good BP control, P<0.001). Multimorbidity was common among hypertensive patients, and was associated with poor BP control. Subjects with coexisting diabetes, heart disease, or chronic kidney disorder should receive more clinical attention to achieve better clinical outcomes.
Citation:
Medication Adherence and Blood Pressure Control Among Hypertensive Patients With Coexisting Long-Term Conditions in Primary Care Settings 2016, 95 (20):e3572 Medicine
Publisher:
Lippincott Williams & Wilkins
Journal:
Medicine, May 2016 - Volume 95 - Issue 20
Issue Date:
May-2016
URI:
http://hdl.handle.net/2436/617328
DOI:
10.1097/MD.0000000000003572
Additional Links:
http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00005792-201605170-00019
Type:
Article
Language:
en
ISSN:
0025-7974
Appears in Collections:
FEHW

Full metadata record

DC FieldValue Language
dc.contributor.authorLi, Yu Tingen
dc.contributor.authorWang, Harry H.X.en
dc.contributor.authorLiu, Kirin Q.L.en
dc.contributor.authorLee, Gabrielle K.Y.en
dc.contributor.authorChan, Wai Manen
dc.contributor.authorGriffiths, Sian M.en
dc.contributor.authorChen, Ruolingen
dc.date.accessioned2016-07-21T14:19:40Z-
dc.date.available2016-07-21T14:19:40Z-
dc.date.issued2016-05-
dc.identifier.citationMedication Adherence and Blood Pressure Control Among Hypertensive Patients With Coexisting Long-Term Conditions in Primary Care Settings 2016, 95 (20):e3572 Medicineen
dc.identifier.issn0025-7974en
dc.identifier.doi10.1097/MD.0000000000003572-
dc.identifier.urihttp://hdl.handle.net/2436/617328-
dc.description.abstractHypertension is a typical example of long-term disease posing formidable challenges to health care. One goal of antihypertensive therapy is to achieve optimal blood pressure (BP) control and reduce co-occurring chronic conditions (multimorbidity). This study aimed to assess the influence of multimorbidity on medication adherence, and to explore the association between poor BP control and multimorbidity, with implications for hypertension management. A cross-sectional design with multistage sampling was adopted to recruit Chinese hypertensive patients attending general out-patient clinics from 3 geographic regions in Hong Kong. A modified systemic sampling methodology with 1 patient as a sampling unit was used to recruit consecutive samples in each general out-patient clinic. Data were collected by face-to-face interviews using a standardized protocol. Poor BP control was defined as having systolic BP/diastolic BP 130/80mm Hg for those with diabetes or chronic kidney disease; and 140/90mmHg for others.Medication adherencewas assessed by a validatedChinese version of the Morisky Medication Adherence Scale. A simple unweighted enumeration was adopted to measure the combinations of coexisting long-term conditions. Binary logistic regression analysis was conducted with medication adherence and multimorbidity as outcome variables, respectively, after controlling for effects of patient-level covariates. The prevalence of multimorbidity was 47.4% (95% confidence interval [CI] 45.4%–49.4%) among a total of 2445 hypertensive patients. The proportion of subjects having 0, 1, and 2 additional long-term conditions was 52.6%, 29.1%, and 18.3%, respectively. The overall rate of poor adherence to medication was 46.6%, whereas the rate of suboptimal BP control was 48.7%. Albeit the influence of multimorbidity on medication adherence was not found to be statistically significant, patients with poorly controlled BP were more likely to have multimorbidity (adjusted odds ratio 2.07, 95% CI 1.70–2.53, P<0.001). Diabetes was the most prevalent concomitant long-term condition among hypertensive patients with poor BP control (38.6%, 95% CI 35.8–41.4 vs 19.7%, 95% CI 17.5–21.9 for patients with good BP control, P<0.001). Multimorbidity was common among hypertensive patients, and was associated with poor BP control. Subjects with coexisting diabetes, heart disease, or chronic kidney disorder should receive more clinical attention to achieve better clinical outcomes.en
dc.language.isoenen
dc.publisherLippincott Williams & Wilkinsen
dc.relation.urlhttp://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00005792-201605170-00019en
dc.rightsArchived with thanks to Medicineen
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectMedication Adherenceen
dc.subjectBlood Pressure Controlen
dc.subjectHypertensive Patientsen
dc.subjectCoexisting Long-Term Conditionsen
dc.subjectPrimary Care Settingsen
dc.titleMedication Adherence and Blood Pressure Control Among Hypertensive Patients With Coexisting Long-Term Conditions in Primary Care Settingsen
dc.typeArticleen
dc.identifier.journalMedicine, May 2016 - Volume 95 - Issue 20en
dc.date.accepted2016-04-11-
rioxxterms.funderThe Direct Grant, Faculty of Medicine, The Chinese University of Hong Kongen
rioxxterms.identifier.projectUoW210716RCen
rioxxterms.versionVoRen
rioxxterms.licenseref.urihttps://creativecommons.org/CC BY-NC-ND 4.0en
rioxxterms.licenseref.startdate2016-07-21en
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