Discordance between medication adherence and blood pressure control in primary care clinics in Negeri Sembilan, Malaysia: The problem of therapeutic inertia
- Author:
Chun Wai Chan
;
Junyi Wang
;
Joanne Johnny Bouniu
;
Parampreet Singh
;
Cheong Lieng Teng
- Publication Type:Journal Article
- Keywords:
primary care;
hypertension;
therapeutic inertia;
medication adherence
- MeSH:
Hypertension;
Blood Pressure
- From:International e-Journal of Science, Medicine and Education
2015;9(3):27-32
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Poor adherence to anti-hypertensive
agents may be a major contributor for suboptimal blood
pressure control among patients with hypertension.
This study was conducted to assess the adherence to
antihypertensive agents using Morisky Medication
Adherence Scale (MMAS-8) among primary care
patients, and to determine whether the blood pressure
control is associated with the level of adherence.
Methodolgy: This cross-sectional study was conducted
between June 2011 and August 2011. Adults with
hypertension older or equal to aged 30 with or without
diabetes were recruited from two public primary care
clinics in Negeri Sembilan, Malaysia. Medication
adherence was assessed using MMAS-8.
Results: Data from 231 patients were analysed, whereby
68% of them had good medication adherence but only
38.1% of the patients had their blood pressure under
control. Statistical analysis failed to find correlation
between adherence and blood pressure control. Twenty
per cent of hypertensive subjects were on beta-blocker
alone, and 37.1% of patients with either diabetes or
proteinuria were not prescribed either angiotensinconverting
enzyme inhibitors (ACEI) or angiotensin
receptor blocker (ARB). Above half the patients
(51.5%) were on monotherapy.
Conclusion: Discordance between adherence to antihypertensive
agents and hypertension control is clearly
shown in this study, and the likely explanation for the
discordance is therapeutic inertia.
Keywords: primary care; hypertension; therapeutic inertia;
medication adherence
- Full text:P020151207420395160030.pdf
