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HİPERTANSİYONLU YAŞLI HASTALARDA İLAÇ TEDAVİSİNE UYUMSUZLUK VE İLİŞKİLİ FAKTÖRLER

Yıl 2024, Cilt: 9 Sayı: 3, 224 - 233, 01.11.2024
https://doi.org/10.35232/estudamhsd.1517070

Öz

Yaklaşık %10-%60 sıklığında olduğu tahmin edilen ilaç uyumsuzluğu yaşlılarda oldukça yaygındır ve önemli bir morbidite nedenidir. Bu çalışmada yaşlı bireylerde antihipertansif ilaç tedavisine uyumsuzluğun sıklığını ve ilişkili faktörleri belirlemek amaçlanmıştır. Kesitsel olarak planlanan çalışmada veriler Samsun ilinde 2017 yılı Mayıs ve Haziran aylarında aile hekimliğine başvuran hastalar ile yüz-yüze görüşülerek toplanmıştır. En az bir yıldır antihipertansif ilaç kullanan, hipertansiyon tanılı 65 yaş ve üzeri bireyler çalışmaya dahil edilmiştir. İlaç uyumunu belirlemek için Antihipertansif İlaç Tedavisine Uyum Ölçeği kullanılmıştır. İlaç uyumsuzluğuna etki eden faktörleri araştırmak amacıyla lojistik regresyon analizi kullanılmıştır. Çalışma grubunun yaş ortalaması 71,8± 6,7 yıldır. İlaç uyumsuzluğu oranı %10,9 olarak saptanmıştır. Logistik regresyon analizi sonucunda bilişsel yetersizliği olma, görmede zorluk yaşama, ilaç alımında sosyal destek alamama, erkek cinsiyet ve bekar olma değişkenlerinin ilaç uyumsuzluğu ile ilişkili olduğu bulunmuştur. Birinci basamakta hipertansiyon kontrolü ve yönetiminde birey odaklı ve kolay anlaşılır tedavi seçenekleri değerlendirilmelidir.

Kaynakça

  • Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223-37. doi:10.1038/s41581-019-0244-2.
  • MA Papadakis. Disease Prevention and health promotion, In: Maxine A. Papadakis, Stephen J. McPhee, Michael W. Rabow, Kenneth R. McQuaid (Eds). Current medical diagnosis and treatment 2023. McGraw-Hill Education; 2023. pp.1-14.
  • Yoon S, Kwan YH, Yap WL, Yap WL, Lim ZY, Phang JK, et al. Factors influencing medication adherence in multi-ethnic Asian patients with chronic diseases in Singapore: A qualitative study. Front Pharmacol. 2023; 14:1124297. doi:10.3389/fphar.2023.1124297.
  • Konstantinou P, Kassianos AP, Georgiou G, Andreas P, Papageorgiou A, Almas I, et al. Barriers, facilitators, and interventions for medication adherence across chronic conditions with the highest nonadherence rates: a scoping review with recommendations for intervention development. Transl Behav Med. 2020;10:1390–8. doi:10.1093/tbm/ibaa118.
  • Cutler RL, Fernandez-Llimos F, Frommer M, Benrimoj C, Garcia-Cardenas V. Economic impact of medication non-adherence by disease groups: A systematic review. BMJ Open. 2018; 8(1):e016982. doi:10.1136/bmjopen-2017-016982.
  • Shahin W, Kennedy GA, Stupans L. The association between social support and medication adherence in patients with hypertension: A systematic review. Pharmacy Practice. 2021;9(2):2300. doi:10.18549/PharmPract.2021.2.2300.
  • He J, Irazola V, Mills KT, Poggio R, Beratarrechea A, Dolan J, et al. Effect of a Community Health Worker-Led Multicomponent Intervention on Blood Pressure Control in Low-Income Patients in Argentina: A Randomized Clinical Trial. JAMA. 2017;318(11):1016–25. doi:10.1001/jama.2017.11358.
  • World Health Organization. (‎2003)‎. Adherence to long-term therapies: Evidence for action. World Health Organization. Available from: https://iris.who.int/handle/10665/42682
  • Peh, KQE, Kwan YH, Goh H, Ramchandani H, Phang JK, Lim ZY, et al. An adaptable framework for factors contributing to medication adherence: Results from a systematic review of 102 conceptual frameworks. J. Gen. Intern Med. 2021;36(9):2784–95. doi:10.1007/s11606-021-06648-1.
  • Emre N, Edirne T, Ozsahin A, Çoban N, Yanık A. The Relationship Between Adherence to Medication and Quality of Life and Health Perception in Hypertensive Patients. Turkish Journal of Family Medicine and Primary Care 2020;14(3):436-42. doi:10.21763/tjfmpc.725974.
  • Ünal B, Ergör G,editors. Türkiye kronik hastalıklar ve risk faktörleri çalışması. Sağlık Bakanlığı, 909, Ankara; 2013.
  • 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.
  • Demirezen E. Türkiye’de ve Almanya’da yaşayan antihipertansif ilaç kullanan Türklerde ilaç tedavisine uyum. İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, Hemşirelik Programı Doktora Tezi, İstanbul, 2006.
  • Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: A practical method for granding the cognitive state of patients for the clinican. J Psychiatr Res.1975;12(3):189-98. doi:10.1016/0022-3956(75)90026-6.
  • Yildiz GB, Ozcelik EU, Kolukisa M, Isık AT, Gürsoy E, Kocaman G, et al. Validity and Reliability Studies of Modified Mini Mental State Examination (MMSE-I) For Turkish Illiterate Patients with Diagnosis of Alzheimer Disease. Turkish Journal of Psychiatry. 2016;27(1):41-6. PMID:27369684.
  • Roebuck MC, Kaestner RJ, Dougherty JS. Impact of Medication Adherence on Health Services Utilization in Medicaid. Medical Care. 2018;56(3):266-73. doi:10.1097/MLR.0000000000000870.
  • Jingjing P, Bin H, Lian W, Yarong L. The Effect of Social Support on Treatment Adherence in Hypertension in China, Patient Prefer Adherence. 2021;15:1953-61. doi:10.2147/PPA.S325793.
  • Ma C. A cross-sectional survey of medication adherence and associated factors for rural patients with hypertension. Appl Nurs Res. 2016;31:94-9. doi:10.1016/j.apnr.2016.01.004.
  • Mollaoglu M, Solmaz G, Mollaoglu M. Adherence to therapy and quality of life in hypertensive patients. Acta clinica Croatica Acta Clin Croat. 2015;54(4):438-44. PMID:27017717
  • Chudiak A, Uchmanowicz I, Mazur G. Relation between cognitive impairment and treatment adherence in elderly hypertensive patients. Clin Interv Aging. 2018;6(13):1409-18. doi:10.2147/CIA.S162701.
  • Calderón-Larrañaga A, Diaz E, Poblador-Plou B, Gimeno-Feliu LA, Abad-Díez JM, Prados-Torres A. Non-adherence to antihypertensive medication: the role of mental and physical comorbidity. Int J Cardiol. 2016;207:310-6. doi:10.1016/j.ijcard.2016.01.069.
  • Kamran A, Ahari SS, Biria M, Malpour A, Heydari H. Determinants of patient’s adherence to hypertension medications: application of health belief model among rural patients. Ann Med Health Sci Res. 2014;4(6):922-7. doi:10.4103/2141-9248.144914.
  • Alhaddad IA, Hamoui O, Hammoudeh A, Mallat S. Treatment adherence and quality of life in patients on antihypertensive medications in a Middle Eastern population: adherence. Vasc Health Risk Manag. 2016;27(12):407-13. doi:10.2147/VHRM.S105921.
  • Uchmanowicz B, Chudiak A, Uchmanowicz I, Rosińczuk J, Froelicher ES. Factors influencing adherence to treatment in older adults with hypertension. Clin Interv Aging. 2018;28(13):2425-41. doi:10.2147/CIA.S182881.
  • Cárdenas-Valladolid J, Martín-Madrazo C, Salinero-Fort MA, de-Santa Pau EC, Abánades-Herranz JC, de Burgos-Lunar C. Prevalence of adherence to treatment in homebound elderly people in primary health care. Drugs Aging. 2010;27(8):641-51. doi:10.2165/11537320-000000000-00000.
  • Abegaz TM, Shehab A, Gebreyohannes EA, Bhagavathula AS, Elnour AA. Nonadherence to antihypertensive drugs: A systematic review and meta-analysis. Medicine (Baltimore). 2017;96(4):e5641. doi:10.1097/MD.0000000000005641. 27. Del Pinto R, Desideri, G, Ferri C, Agabiti Rosei E. Real-world Antihypertensive Treatment Patterns, Treatment Adherence, and Blood Pressure Control in the Elderly: An Italian Awareness-raising Campaign on Hypertension by Senior Italia FederAnziani, the Italian Society of Hypertension and the Italian Federation of General Practitioners. High Blood Press Cardiovasc Prev. 2021;28:457–66. doi:10.1007/s40292-021-00465-7. 28. Kasar Sayın K, Karadakovan A. Elderly individuals investigation of antihypertensive drugs use error. Turk J Card Nur. 2017;8(15):20-7. doi:10.5543/khd.2017.39200.

FACTORS ASSOCIATED WITH NON-ADHERENCE TO MEDICATION IN ELDERLY WITH HYPERTENSION

Yıl 2024, Cilt: 9 Sayı: 3, 224 - 233, 01.11.2024
https://doi.org/10.35232/estudamhsd.1517070

Öz

Non-adherence to medication, estimated to be approximately 10%–60%, is quite common in the elderly and is an important cause of morbidity. In this study, we aimed to determine the rates of non-adherence to antihypertensive medications and related factors in the elderly. This cross-sectional study was conducted in primary healthcare facilities in Samsun, Turkey, during May and June 2017, involving a face-to-face interview with patients. The inclusion criteria were a diagnosis of hypertension, use of antihypertensive medication for at least one year, age 65 years and older, and ability to communicate verbally. The Hypertension Medication Adherence Scale was used to assess adherence to treatment. Multivariate logistic regression analysis was used to determine the evaluated variables related to poor adherence. The mean age of the study group was 71.8 ± 6.7 years. The frequency of non-adherence to medication was 10.9%. According to the results of the logistic regression analysis, cognitive impairment, visual impairment, having no social support for medicine intake, male gender, and being single were significantly associated with non-adherence to antihypertensive medication. To improve medication adherence in primary care, simplified treatment options should be offered and a patient-oriented treatment plan should be planned.

Kaynakça

  • Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223-37. doi:10.1038/s41581-019-0244-2.
  • MA Papadakis. Disease Prevention and health promotion, In: Maxine A. Papadakis, Stephen J. McPhee, Michael W. Rabow, Kenneth R. McQuaid (Eds). Current medical diagnosis and treatment 2023. McGraw-Hill Education; 2023. pp.1-14.
  • Yoon S, Kwan YH, Yap WL, Yap WL, Lim ZY, Phang JK, et al. Factors influencing medication adherence in multi-ethnic Asian patients with chronic diseases in Singapore: A qualitative study. Front Pharmacol. 2023; 14:1124297. doi:10.3389/fphar.2023.1124297.
  • Konstantinou P, Kassianos AP, Georgiou G, Andreas P, Papageorgiou A, Almas I, et al. Barriers, facilitators, and interventions for medication adherence across chronic conditions with the highest nonadherence rates: a scoping review with recommendations for intervention development. Transl Behav Med. 2020;10:1390–8. doi:10.1093/tbm/ibaa118.
  • Cutler RL, Fernandez-Llimos F, Frommer M, Benrimoj C, Garcia-Cardenas V. Economic impact of medication non-adherence by disease groups: A systematic review. BMJ Open. 2018; 8(1):e016982. doi:10.1136/bmjopen-2017-016982.
  • Shahin W, Kennedy GA, Stupans L. The association between social support and medication adherence in patients with hypertension: A systematic review. Pharmacy Practice. 2021;9(2):2300. doi:10.18549/PharmPract.2021.2.2300.
  • He J, Irazola V, Mills KT, Poggio R, Beratarrechea A, Dolan J, et al. Effect of a Community Health Worker-Led Multicomponent Intervention on Blood Pressure Control in Low-Income Patients in Argentina: A Randomized Clinical Trial. JAMA. 2017;318(11):1016–25. doi:10.1001/jama.2017.11358.
  • World Health Organization. (‎2003)‎. Adherence to long-term therapies: Evidence for action. World Health Organization. Available from: https://iris.who.int/handle/10665/42682
  • Peh, KQE, Kwan YH, Goh H, Ramchandani H, Phang JK, Lim ZY, et al. An adaptable framework for factors contributing to medication adherence: Results from a systematic review of 102 conceptual frameworks. J. Gen. Intern Med. 2021;36(9):2784–95. doi:10.1007/s11606-021-06648-1.
  • Emre N, Edirne T, Ozsahin A, Çoban N, Yanık A. The Relationship Between Adherence to Medication and Quality of Life and Health Perception in Hypertensive Patients. Turkish Journal of Family Medicine and Primary Care 2020;14(3):436-42. doi:10.21763/tjfmpc.725974.
  • Ünal B, Ergör G,editors. Türkiye kronik hastalıklar ve risk faktörleri çalışması. Sağlık Bakanlığı, 909, Ankara; 2013.
  • 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.
  • Demirezen E. Türkiye’de ve Almanya’da yaşayan antihipertansif ilaç kullanan Türklerde ilaç tedavisine uyum. İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, Hemşirelik Programı Doktora Tezi, İstanbul, 2006.
  • Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: A practical method for granding the cognitive state of patients for the clinican. J Psychiatr Res.1975;12(3):189-98. doi:10.1016/0022-3956(75)90026-6.
  • Yildiz GB, Ozcelik EU, Kolukisa M, Isık AT, Gürsoy E, Kocaman G, et al. Validity and Reliability Studies of Modified Mini Mental State Examination (MMSE-I) For Turkish Illiterate Patients with Diagnosis of Alzheimer Disease. Turkish Journal of Psychiatry. 2016;27(1):41-6. PMID:27369684.
  • Roebuck MC, Kaestner RJ, Dougherty JS. Impact of Medication Adherence on Health Services Utilization in Medicaid. Medical Care. 2018;56(3):266-73. doi:10.1097/MLR.0000000000000870.
  • Jingjing P, Bin H, Lian W, Yarong L. The Effect of Social Support on Treatment Adherence in Hypertension in China, Patient Prefer Adherence. 2021;15:1953-61. doi:10.2147/PPA.S325793.
  • Ma C. A cross-sectional survey of medication adherence and associated factors for rural patients with hypertension. Appl Nurs Res. 2016;31:94-9. doi:10.1016/j.apnr.2016.01.004.
  • Mollaoglu M, Solmaz G, Mollaoglu M. Adherence to therapy and quality of life in hypertensive patients. Acta clinica Croatica Acta Clin Croat. 2015;54(4):438-44. PMID:27017717
  • Chudiak A, Uchmanowicz I, Mazur G. Relation between cognitive impairment and treatment adherence in elderly hypertensive patients. Clin Interv Aging. 2018;6(13):1409-18. doi:10.2147/CIA.S162701.
  • Calderón-Larrañaga A, Diaz E, Poblador-Plou B, Gimeno-Feliu LA, Abad-Díez JM, Prados-Torres A. Non-adherence to antihypertensive medication: the role of mental and physical comorbidity. Int J Cardiol. 2016;207:310-6. doi:10.1016/j.ijcard.2016.01.069.
  • Kamran A, Ahari SS, Biria M, Malpour A, Heydari H. Determinants of patient’s adherence to hypertension medications: application of health belief model among rural patients. Ann Med Health Sci Res. 2014;4(6):922-7. doi:10.4103/2141-9248.144914.
  • Alhaddad IA, Hamoui O, Hammoudeh A, Mallat S. Treatment adherence and quality of life in patients on antihypertensive medications in a Middle Eastern population: adherence. Vasc Health Risk Manag. 2016;27(12):407-13. doi:10.2147/VHRM.S105921.
  • Uchmanowicz B, Chudiak A, Uchmanowicz I, Rosińczuk J, Froelicher ES. Factors influencing adherence to treatment in older adults with hypertension. Clin Interv Aging. 2018;28(13):2425-41. doi:10.2147/CIA.S182881.
  • Cárdenas-Valladolid J, Martín-Madrazo C, Salinero-Fort MA, de-Santa Pau EC, Abánades-Herranz JC, de Burgos-Lunar C. Prevalence of adherence to treatment in homebound elderly people in primary health care. Drugs Aging. 2010;27(8):641-51. doi:10.2165/11537320-000000000-00000.
  • Abegaz TM, Shehab A, Gebreyohannes EA, Bhagavathula AS, Elnour AA. Nonadherence to antihypertensive drugs: A systematic review and meta-analysis. Medicine (Baltimore). 2017;96(4):e5641. doi:10.1097/MD.0000000000005641. 27. Del Pinto R, Desideri, G, Ferri C, Agabiti Rosei E. Real-world Antihypertensive Treatment Patterns, Treatment Adherence, and Blood Pressure Control in the Elderly: An Italian Awareness-raising Campaign on Hypertension by Senior Italia FederAnziani, the Italian Society of Hypertension and the Italian Federation of General Practitioners. High Blood Press Cardiovasc Prev. 2021;28:457–66. doi:10.1007/s40292-021-00465-7. 28. Kasar Sayın K, Karadakovan A. Elderly individuals investigation of antihypertensive drugs use error. Turk J Card Nur. 2017;8(15):20-7. doi:10.5543/khd.2017.39200.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Koruyucu Sağlık Hizmetleri
Bölüm Araştırma Makalesi
Yazarlar

Gülçin Elmas Akıncı 0000-0002-2158-7678

Cihad Dündar 0000-0001-9658-2540

Yayımlanma Tarihi 1 Kasım 2024
Gönderilme Tarihi 16 Temmuz 2024
Kabul Tarihi 9 Eylül 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 9 Sayı: 3

Kaynak Göster

Vancouver Akıncı GE, Dündar C. FACTORS ASSOCIATED WITH NON-ADHERENCE TO MEDICATION IN ELDERLY WITH HYPERTENSION. ESTÜDAM Halk Sağlığı Dergisi. 2024;9(3):224-33.

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