The Relationship Between Adherence to Medication and Quality of Life and Health Perception in Hypertensive Patients

Öz

Introduction: Medication adherence is an important component of disease management in the treatment of hypertension. The purpose of this study is to examine the relationship between medication adherence, quality of life and health perception in patients with hypertension. Method: This descriptive-cross-sectional study was performed in patients diagnosed with hypertension in a family health center in the city center of Denizli. In collecting data, sociodemographic characteristics, Hypertension Compliance Assessment Scale, quality of life scale and health perception scale were used. Results: The mean age of 117 patients who participated in the study was 62.85 ± 9.29, and 55.6% were women. The mean score of the participants' compliance to drug treatment scale was 3.98 ± 1.73 and 93.2% of them were in compliance with drug treatment. The mean health perception score of the participants was 49.76 ± 6.50 and a negative correlation was found between the health perception score and the drug treatment compliance score (r=-0.211; p=0.023). The summary score of physical components of the quality of life subscales was 43.59 ± 5.69; The summary mean score of mental components was 47.10 ± 6.62. No correlation was found between drug treatment compliance score and quality of life subscales. No correlation was found between drug treatment compliance score and quality of life subscales. In addition, statistically significant blood pressure of those with good compliance with medication was under control (p=0.003). Conclusion: It was determined that the patients' compliance to the treatment affects their health perceptions but there is no relation with the quality of life. In addition, blood pressure values of patients with high compliance with medication were under control, and home blood pressure measurements were found to increase drug compliance.

Anahtar Kelimeler

• hypertension
• medication adherence
• quality of life
• health
• perception

Hipertansiyon Hastalarında İlaç Tedavisine Uyumun Yaşam Kalitesi ve Sağlık Algısıyla İlişkisi

Öz

Giriş: Hipertansiyon tedavisinde ilaç uyumu, hastalık yönetiminin önemli bir bileşenidir. Çalışmamızın amacı, hipertansiyon tanısı olan hastalardaki ilaç uyumunun, yaşam kalitesi ve sağlık algısıyla ilişkisini incelemektir. Yöntem: Tanımlayıcı-kesitsel nitelikte olan bu çalışma, Denizli il merkezinde bulunan bir aile sağlığı merkezinde, hipertansiyon tanısı almış hastalarda yapılmıştır. Verilerin toplanmasında, sosyodemografik özellikler, antihipertansif ilaç uyum ölçeği, yaşam kalitesi ölçeği ve sağlık algısı ölçeği kullanılmıştır. Bulgular: Çalışmaya katılan 117 hastanın yaş ortalaması 62,85±9,29 olup, %55,6’sı kadındı. Katılımcıların, ilaç tedavisine uyum ölçek puanı ortalaması 3,98± 1,73 idi ve %93,2’si ilaç tedavisine uymaktaydı. Katılımcıların sağlık algısı ortalama puanı 49,76±6,50 idi ve sağlık algısı puanı ile ilaç tedavisine uyum puanı arasında negatif yönde zayıf düzeyde ilişki bulunmuştur (r=-0,211; p=0,023). Yaşam kalitesi alt ölçeklerinden fiziksel bileşenlerin özeti ortalama puanı 43,59±5,69; mental bileşenlerin özeti ortalama puanı 47,10±6,62 bulunmuştur. İlaç tedavisine uyum puanı ile yaşam kalitesi alt ölçekleri arasında ilişki saptanamamıştır. Ayrıca ilaç tedavisine uyumları iyi olanların istatistiksel olarak anlamlı oranda tansiyonlarının kontrol altında olduğu tespit edilmiştir (p=0,003). Sonuç: Çalışmamızda, hastaların ilaç tedavisine uyumunu, sağlık algısının etkilediği ancak yaşam kalitesiyle ilişkili olmadığı gösterilmiştir. Ayrıca ilaç tedavisine uyumu iyi olan hastaların tansiyon değerleri kontrol altındaydı ve evde tansiyon ölçümlerinin de ilaç uyumunu artırdığı tespit edilmiştir

Anahtar Kelimeler

• Hipertansiyon
• İlaç tedavisine uyum
• yaşam kalitesi
• sağlık
• kabul

Kaynakça

1. 1. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020 Apr;16(4):223-37.
2. 2. WHO | Global status report on noncommunicable diseases 2014 [Internet]. WHO. World Health Organization; [a.yer 13 Nisan 2020]. Erişim adresi: http://www.who.int/nmh/publications/ncd-status-report-2014/en/
3. 3. Sengul S, Akpolat T, Erdem Y, Derici U, Arici M, Sindel S, vd. Changes in hypertension prevalence, awareness, treatment, and control rates in Turkey from 2003 to 2012. J Hypertens. 2016;34(6):1208-17.
4. 4. Arici M, Turgan C, Altun B, Sindel S, Erbay B, Derici U, vd. Hypertension incidence in Turkey (HinT): a population-based study. J Hypertens. 2010;28(2):240-4.
5. 5. Cramer J. Cramer J. Medicine partnerships. Heart. 2003 May;89(suppl 2):ii19-21.
6. 6. Saleem F, Hassali MA, Shafie AA, Awad GA, Atif M, ul Haq N, vd. Does treatment adherence correlates with health related quality of life? Findings from a cross sectional study. BMC Public Health. 2012 Apr;12:318.
7. 7. Önal AE, Erbil S, Gürtekin B, Ayvaz Ö, Özel S, Cevizci S, Güngör G. İki ilköğretim okulunda öğrencilerin kendi sağlıklarını algılama düzeyi ve bildikleri sağlık sorunları”. Nobel Medicus, 2009;5(2): 24-48.
8. 8. Al-Noumani H, Wu JR, Barksdale D, Alkhasawneh E, Knafl G, Sherwood G. Relationship between medication adherence and health beliefs among patients with hypertension in Oman: Pilot study. Sultan Qaboos University Medical Journal. 2017 Aug;17(3):e329.

9. 9. Yue Z, Bin W, Weilin Q, Aifang Y. Effect of medication adherence on blood pressure control and risk factors for antihypertensive medication adherence. J Eval Clin Pract. 2015 Feb;21(1):166-72.
10. 10. ESC/ESH Arterial Hypertension (Management of) Guidelines 2018 [Internet]. [a.yer 14 Nisan 2020]. Erişim adresi: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Arterial-Hypertension-Management-of,
11. 11. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence Medical care. 1986:67-74.
12. 12. 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: 30-31.
13. 13. Kadıoğlu H, Yıldız A. Sağlık Algısı Ölçeği’nin Türkçe çevriminin geçerlilik ve güvenilirliği. Turkiye Klinikleri Journal of Medical Sciences. 2012;32(1):47-53.
14. 14. Kilic C. General health questionnaire: Reliability and validity study. Turkish Journal of Psychiatry. 1996;7(1):3-9.
15. 15. Kilic C, Rezaki M, Rezaki B, et al. General health questionnaire (GHQ12 & GHQ28): Psychometric properties and factor structure of the scales in a Turkish primary care sample. Social Psychiatry and Psychiatric Epidemiology. 1997;32(6):327-331.
16. 16. Anadol Z, Di̇şci̇gi̇l G. Hipertansif hastalarda tedavi uyumunu etkileyen faktörler. Turkiye Klinikleri J Cardiovasc Sci. 2009;21(2):184-90.
17. 17. Mert H, Kuruoğlu E. Multidisipliner bir özel çalışma modülü araştırması: Hipertansiyon hastalarının tedaviye uyumlarının incelenmesi. Turkish Journal of Family Practice/Türkiye Aile Hekimligi Dergisi. 2011 Jan 1;15(1).
18. 18. Al-Ramahi R. Adherence to medications and associated factors: A cross-sectional study among Palestinian hypertensive patients. J Epidemiol Glob Health. 2015 Jun;5(2):125-32.
19. 19. 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;12:407-13.
20. 20. Arslan DE, Akça NK. Kırsal alanda yaşayan hipertansiyon hastalarının ilaç tedavisine uyumları. Bozok Tıp Dergisi, 2019;10(1):55-62.
21. 21. Zyoud SH, Al-Jabi SW, Sweileh WM, Wildali AH, Saleem HM, Aysa HA, vd. Health-related quality of life associated with treatment adherence in patients with hypertension: a cross-sectional study. Int J Cardiol. 2013 Oct;168(3):2981-3.
22. 22. Shimamoto K, Ando K, Fujita T, Hasebe N, Higaki J, Horiuchi M, Imai Y, Imaizumi T, Ishimitsu T, Ito M, et al. Japanese society of hypertension committee for guidelines for the management of hypertension. The Japanese society of hypertension guidelines for the management of hypertension (JSH 2014). Hypertens Res. 2014;37:253–390. doi:10.1038/hr.2014.20.
23. 23. Imai Y, Ohkubo T, Kikuya M, Hashimoto J. Practical aspect of monitoring hypertension based on self-measured blood pressure at home. Intern Med. 2004;43:771–78.
24. 24. Cheng, Hao‐Min, et al. Asian management of hypertension: Current status, home blood pressure, and specific concerns in Taiwan. The Journal of Clinical Hypertension. 2020;22:511-514.
25. 25. Waeber B. Treatment strategy to control blood pressure optimally in hypertensive patients. Blood Press. 2001;10(2):62-73.
26. 26. Yiannakopoulou EC, Papadopulos JS, Cokkinos DV, Mountokalakis TD. Adherence to antihypertensive treatment: a critical factor for blood pressure control. Eur J Cardiovasc Prev Rehabil. 2005 Jun;12(3):243-9.
27. 27. Park NH, Song MS, Shin SY, Jeong J-H, Lee HY. The effects of medication adherence and health literacy on health-related quality of life in older people with hypertension. Int J Older People Nurs. 2018;13(3):e12196.
28. 28. Carballo E, Cadarso-Suárez C, Carrera I, Fraga J, de la Fuente J, Ocampo A, vd. Assessing relationships between health-related quality of life and adherence to antiretroviral therapy. Qual Life Res. 2004;13(3):587-99.
29. 29. Takemura, Masaya, et al. Repeated instruction on inhalation technique improves adherence to the therapeutic regimen in asthma. Journal of Asthma. 2010 Mar;47(2):202-208.
30. 30. Rajpura JR, Nayak R. Role of illness perceptions and medication beliefs on medication compliance of elderly hypertensive cohorts. J Pharm Pract. 2014;27(1):19-24.
31. 31. Haddad C, Hallit S, Salhab M, Hajj A, Sarkis A, Ayoub EN, vd. Association Between Adherence to Statins, Illness Perception, Treatment Satisfaction, and Quality of Life among Lebanese patients. J Cardiovasc Pharmacol Ther. 2018;23(5):414-22.