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dc.contributor.authorMorrison, V.L.
dc.contributor.authorHolmes, E.A.F.
dc.contributor.authorParveen, Sahdia
dc.contributor.authorPlumpton, C.O.
dc.contributor.authorClyne, W.
dc.contributor.authorde Geest, S.
dc.contributor.authorDobbels, F.
dc.contributor.authorVrijens, B.
dc.contributor.authorKardas, P.
dc.contributor.authorHughes, D.A.
dc.date.accessioned2018-06-12T11:00:08Z
dc.date.available2018-06-12T11:00:08Z
dc.date.issued2015-03
dc.identifier.citationMorrison 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.en_US
dc.identifier.urihttp://hdl.handle.net/10454/16143
dc.descriptionNoen_US
dc.description.abstractBackground 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.en_US
dc.language.isoenen_US
dc.relation.isreferencedbyhttps://doi.org/10.1016/j.jval.2014.12.013en_US
dc.subjectAdherenceen_US
dc.subjectBehavioral economicsen_US
dc.subjecthealth psychologyen_US
dc.subjectHypertensionen_US
dc.subjectSelf-efficacyen_US
dc.titlePredictors of self-reported adherence to antihypertensive medicines: A multinational, cross-sectional surveyen_US
dc.status.refereedYesen_US
dc.date.application2015-03-13
dc.typeArticleen_US
dc.type.versionNo full-text in the repositoryen_US


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