Higher levels of perceived net barriers to treatment were associated with increased noncompliance with antihypertensive medication (overall rate 47%), accounting for 50% of the noncompliance.
Cross-Sectional (n=197)
Do perceived net barriers reduce compliance with antihypertensive medication in subjects attending a specialized clinic for hypertension?
Perceived barriers significantly contribute to noncompliance with antihypertensive medication, particularly in younger patients or those in early stages of treatment.
Noncompliance with antihypertensive medication remains an obstacle to the management of hypertension, and despite research efforts over the past decade, the predictors of noncompliance remain unclear. According to values expectancy theory, individuals rationally choose noncompliance when the barriers or costs of treatment outweigh the expected benefits. Noncompliance, therefore, is likely to occur when net costs of treatment are high. Using a cross-sectional study design among subjects (n = 197) attending a specialized clinic for hypertension, we measured "net barriers" (costs), self-reported compliance, and possible determinants of noncompliance, including socio-demographics, the medical regimen, and locus of control. The effect of each quartile of the net barriers score (none, low, moderate, and high) on compliance, controlling for potential effect modifiers, was assessed using logistic regression modeling. Noncompliance (47%) was associated with younger age, higher salt use, longer duration of treatment, and higher levels of net barriers, but duration of treatment modified the effect of net barriers. Among subjects in short-term treatment, noncompliance increased with severity of net barriers suggesting a dose-response effect. In contrast, patients in long-term treatment showed no dose-response effect but a consistent association between noncompliance and levels of net barriers. Subjects at greater risk for noncompliance, however, were those who reported high net barriers, regardless of duration of treatment. Net barriers accounted for 50% of the noncompliance and appeared most important for patients who were younger or in the early stages of treatment. Implications for health care providers are discussed.
Richardson et al. (Wed,) conducted a cross-sectional in Hypertension (n=197). Perceived net barriers to treatment vs. Lower levels of net barriers was evaluated on Noncompliance with antihypertensive medication. Higher levels of perceived net barriers to treatment were associated with increased noncompliance with antihypertensive medication (overall rate 47%), accounting for 50% of the noncompliance.
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