What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=249). Intervention: Antihypertensive medications. Primary outcome: Poor adherence to antihypertensive medications (<80%) associated with believing symptoms were caused by medications (AOR 3.249, 95% CI 1.248-8.456, p=0.016).

January 3, 2019Open Access

Adverse effects and non-adherence to antihypertensive medications in University of Gondar Comprehensive Specialized Hospital

Q: What are the key findings of this study?

Believing that symptoms were caused by antihypertensive medications significantly increased the odds of poor medication adherence among hypertensive patients (AOR 3.249).

Key Result

Believing that symptoms were caused by antihypertensive medications significantly increased the odds of poor medication adherence among hypertensive patients (AOR 3.249).

Study Design

Type

Cross-Sectional (n=249)

Multicenter

Structured PICO

Do adverse effects of antihypertensive medications reduce medication adherence in hypertensive patients?

Population

249 hypertensive patients aged 18 years and above taking one or more antihypertensive medications for at least 3 months, mean age 56.51 years, 53% female, at the ambulatory clinic of University of Gondar Comprehensive Specialized Hospital.

Intervention

Antihypertensive medications (and their associated adverse effects)

Outcome

Level of adherence to antihypertensive medications (calculated by subtracting missed doses from intended doses, with ≥80% considered good adherence)patient reported

Adverse effects such as tiredness, muscle pain, and poor sleep, as well as the patient's belief that symptoms are caused by their medications, significantly contribute to non-adherence among hypertensive patients.

Main Result

Effect estimate: AOR 3.249 (95% CI 1.248-8.456)

p-value: p=0.016

Limitations

Single-center cross-sectional study with a small sample size, limiting generalization
Relied on patient reports of adverse reactions, which may be subject to recall bias
Impossible to differentiate whether the adverse effects were due to the antihypertensive medications or other medications the patients were taking

Abstract

A considerable proportion of cardiovascular events could be attributed to poor adherence to antihypertensive medications. Adverse effects can be severe enough to affect adherence to antihypertensive medications. This study aimed to measure the contribution of adverse effects on antihypertensive medications adherence. The study was conducted from May 1 to June 30, 2017, at the ambulatory clinic of University of Gondar Comprehensive Specialized Hospital (UOGCSH) in Gondar town. A binary logistic regression was performed to determine the significance of the association between adverse effects and adherence to antihypertensive medications. An institution-based cross-sectional study was conducted by administering a questionnaire to hypertensive patients who came for follow-up at the ambulatory clinic of UOGCSH. Level of adherence to antihypertensive medications was used as outcome measure. A total of 249 patients were included in the final analysis with a mean age of 56.51 years and a female majority (53%). The following variables were identified as predictors of poor adherence: tiredness AOR (95% CI): 3.802 (1.723–8.391), p = 0.001, muscle pain AOR (95% CI): 5.199 (1.407–19.214), p = 0.013, poor sleep AOR (95% CI): 4.891 (1.578–15.160), p = 0.006 and, believing that the symptoms were caused by antihypertensive medications AOR (95% CI): 3.249 (1.248–8.456), p = 0.016. Adverse effect significantly contributes to antihypertensive medication non-adherence among hypertensive patients.

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