Determinants of medication adherence and blood pressure control among hypertensive patients in Hong Kong: A cross-sectional study

Determinants of medication adherence and blood pressure control among hypertensive patients in Hong Kong: A cross-sectional study

Abstract Introduction Despite effective treatments, suboptimal medication adherence substantially hinders blood pressure (BP) control among hypertensive patients. This study aimed to evaluate the determinants of medication adherence and BP control among hypertensive patients in Hong Kong. Methods A...

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Published in:International journal of cardiology Vol. 182; pp. 250 - 257
Main Authors: Kang, Candy D, Tsang, Prilla P.M, Li, Winson T.L, Wang, Harry H.X, Liu, Kirin Q.L, Griffiths, Sian M, Wong, Martin C.S
Format: Journal Article
Language:English
Published: Netherlands Elsevier Ireland Ltd 01-03-2015
Subjects:
Adult
Aged
Antihypertensive Agents - therapeutic use
Blood Pressure - drug effects
Blood Pressure - physiology
Blood pressure control
Cardiovascular
Cross-Sectional Studies
Cross-sectional study
Determinant
Female
Hong Kong
Hong Kong - epidemiology
Humans
Hypertension
Hypertension - drug therapy
Hypertension - epidemiology
Hypertension - physiopathology
Male
Medication adherence
Medication Adherence - statistics & numerical data
Middle Aged
Morbidity - trends
Odds Ratio
Risk Assessment - methods
Treatment Outcome
Hong Kong
Adjusted odds ratio
Knowledge overall score
Hypertension
Medication adherence
World Health Organization
Body-mass index
AOR
Hong Kong
Blood pressure control
Determinant
IPOS
BP
KOS
Clinical Research Ethics Committee
CREC
8-Item Morisky Medication Adherence Scale
Chinese version of Brief Illness Perception Questionnaire
Blood pressure
Cross-sectional study
MMAS-8
C-BIPQ
WHO
BMI
Illness perception overall score
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Summary:Abstract Introduction Despite effective treatments, suboptimal medication adherence substantially hinders blood pressure (BP) control among hypertensive patients. This study aimed to evaluate the determinants of medication adherence and BP control among hypertensive patients in Hong Kong. Methods A cross-sectional study was conducted. Adult patients aged > 18 years taking at least one type of antihypertensive drugs were recruited from four clinics in Hong Kong. Each patient completed a self-administered questionnaire, including socio-demographic variables and items related to knowledge, illness perception and medication adherence. Medication adherence was measured by the eight-item Morisky Medication Adherence Scale (MMAS-8), with a score > 6 defined as “good adherence”. BP was measured, and optimal control was defined as systolic BP < 140 mm Hg and diastolic BP < 90 mm Hg. Results Among 2445 patients, 55.1% and 52.5% had optimal medication adherence and BP control, respectively. Binary logistic regression analyses were conducted with optimal medication adherence and BP control, respectively, as the outcome variables. Advanced age (adjusted odds ratio [aOR] 1.012, 95% CI 1.002–1.022, p = 0.014), unemployment (aOR for employed 0.782, 95% CI 0.628–0.975, p = 0.029), and good self-perceived health status (aOR 2.155, 95% CI 1.711–2.714, p < 0.001) were associated with good adherence; whereas being married (aOR 1.265, 95% CI 1.038–1.542, p = 0.020) and having no co-morbidity (aOR for morbidity count 0.713, 95% CI 0.639–0.796, p < 0.001) were associated with optimal BP control. Conclusion Evidence-based, adherence-enhancing interventions should be targeted on younger subjects; employed patients; and those with poor self-perceived health status. Patients who are single and those with comorbidities should be closely monitored for their BP control.
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ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2014.12.064