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    Predictors of self-reported adherence to antihypertensive medicines: A multinational, cross-sectional survey

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    Publication date
    2015-03
    Author
    Morrison, V.L.
    Holmes, E.A.F.
    Parveen, Sahdia
    Plumpton, C.O.
    Clyne, W.
    de Geest, S.
    Dobbels, F.
    Vrijens, B.
    Kardas, P.
    Hughes, D.A.
    Keyword
    Adherence
    Behavioral economics
    health psychology
    Hypertension
    Self-efficacy
    Peer-Reviewed
    Yes
    
    Metadata
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    Abstract
    Background Nonadherence to antihypertensive medicines limits their effectiveness, increases the risk of adverse health outcome, and is associated with significant health care costs. The multiple causes of nonadherence differ both within and between patients and are influenced by patients’ care settings. Objectives The objective of this article was to identify determinants of patient nonadherence to antihypertensive medicines, drawing from psychosocial and economic models of behavior. Methods Outpatients with hypertension from Austria, Belgium, England, Germany, Greece, Hungary, The Netherlands, Poland, and Wales were recruited to a cross-sectional online survey. Nonadherence to medicines was assessed using the Morisky Medication Adherence Scale (primary outcome) and the Medication Adherence Rating Scale. Associations with adherence and nonadherence were tested for demographic, clinical, and psychosocial factors. Results A total of 2595 patients completed the questionnaire. The percentage of patients classed as nonadherent ranged from 24% in The Netherlands to 70% in Hungary. Low age, low self-efficacy, and respondents’ perceptions of their illness and cost-related barriers were associated with nonadherence measured on the Morisky Medication Adherence Scale across several countries. In multilevel, multivariate analysis, low self-efficacy (odds ratio = 0.73; 95% confidence interval 0.70–0.77) and a high number of perceived barriers to taking medicines (odds ratio = 1.70; 95% confidence interval 1.38–2.09) were the main significant determinants of nonadherence. Country differences explained 11% of the variance in nonadherence. Conclusions Among the variables measured, patients’ adherence to antihypertensive medicines is influenced primarily by their self-efficacy, illness beliefs, and perceived barriers. These should be targets for interventions for improving adherence, as should an appreciation of differences among the countries in which they are being delivered.
    URI
    http://hdl.handle.net/10454/16143
    Version
    No full-text in the repository
    Citation
    Morrison VL, Holmes EAF, Parveen S et al (2015) Predictors of self-reported adherence to antihypertensive medicines: A multinational, cross-sectional survey. Value in Health. 18(2): 206-216.
    Link to publisher’s version
    https://doi.org/10.1016/j.jval.2014.12.013
    Type
    Article
    Collections
    Health Studies Publications

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