Impact of adverse drug events and treatment satisfaction on patient adherence with antihypertensive medication - a study in ambulatory patients

Derbew Fikadu Berhe; Katja Taxis; Flora M Haaijer-Ruskamp; Afework Mulugeta; Yewondwossen Tadesse Mengistu; Johannes G M Burgerhof; Peter G. M.  Mol

doi:10.1111/bcp.13312

Impact of adverse drug events and treatment satisfaction on patient adherence with antihypertensive medication - a study in ambulatory patients

Derbew Fikadu Berhe, Katja Taxis, Flora M Haaijer-Ruskamp, Afework Mulugeta, Yewondwossen Tadesse Mengistu, Johannes G M Burgerhof, Peter G. M. Mol

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

AIMS

The aim of the present study was to evaluate the impact of adverse drug events (ADEs) and treatment satisfaction on antihypertensive medication adherence.

METHODS

A cross-sectional study was conducted in six public hospitals in Ethiopia. We included adult ambulatory patients on antihypertensive medication. Adherence was measured using the eight-point Morisky Medication Adherence Scale, which categorizes as low (0-5), medium (6-7) and high (8) adherence. Treatment satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM) version 1.4, which included questions about ADEs. Data were analysed using generalized ordered logistic regression with 95% confidence intervals (CIs).

RESULTS

We included 925 out of 968 patients. Overall, 42% of patients scored low, 37% medium and 21% high adherence. Satisfaction with treatment was low, with a mean (standard deviation) TSQM score for global satisfaction of 51 (14). A total of 193 (21%) patients experienced 421 ADEs - mainly dyspeptic symptoms (12%), headache (11%) and cough (11). Experiencing more ADEs reduced the odds of being adherent [low vs. medium/high: odds ratio (OR) OR1 0.77 (95% CI 0.67, 0.89), and low/medium vs. high: OR2 0.55 (05% CI 0.41, 0.73)]. Being more satisfied increased the odds of being adherent [low vs. medium/high: OR1 1.02 (95% CI 1.01, 1.03)]. Taking medication > 1 year [OR1 = 2, 0.60 (95% CI 0.43, 0.83)] and taking calcium channel blockers [OR1 = 2 0.71 (95% CI 0.54, 0.92)] decreased the odds for both low vs. medium/high and low/medium vs. high adherence.

CONCLUSIONS

Only one in five patients reported perfect (high) adherence to their antihypertensive treatment regimen. Experiencing ADEs and being dissatisfied with treatment were associated with lower adherence. In addition to addressing treatment satisfaction and drug safety in first-world countries, these should also be addressed in resource-poor settings, within patient consultations, to enhance adherence.

Original language	English
Pages (from-to)	2107-2117
Number of pages	11
Journal	British Journal of Clinical Pharmacology
Volume	83
Issue number	9
Early online date	15-Jun-2017
DOIs	https://doi.org/10.1111/bcp.13312
Publication status	Published - Sept-2017

Keywords

adverse drug event
ambulatory patients
antihypertensive medication
generalized ordered logistic regression
hypertension
medication adherence
treatment satisfaction
HYPERTENSIVE PATIENTS
CONCISE GUIDE
PHARMACOLOGY
ASSOCIATION
VALIDATION
THERAPY
SCALE
LINK

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10.1111/bcp.13312

Impact of adverse drug events and treatment satisfaction on patient adherence with antihypertensive medicationFinal publisher's version, 342 KBLicence: Taverne

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@article{1ffcef16a3674dcbb9d3d27a6d0e0433,

title = "Impact of adverse drug events and treatment satisfaction on patient adherence with antihypertensive medication - a study in ambulatory patients",

abstract = "AIMSThe aim of the present study was to evaluate the impact of adverse drug events (ADEs) and treatment satisfaction on antihypertensive medication adherence.METHODSA cross-sectional study was conducted in six public hospitals in Ethiopia. We included adult ambulatory patients on antihypertensive medication. Adherence was measured using the eight-point Morisky Medication Adherence Scale, which categorizes as low (0-5), medium (6-7) and high (8) adherence. Treatment satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM) version 1.4, which included questions about ADEs. Data were analysed using generalized ordered logistic regression with 95% confidence intervals (CIs).RESULTSWe included 925 out of 968 patients. Overall, 42% of patients scored low, 37% medium and 21% high adherence. Satisfaction with treatment was low, with a mean (standard deviation) TSQM score for global satisfaction of 51 (14). A total of 193 (21%) patients experienced 421 ADEs - mainly dyspeptic symptoms (12%), headache (11%) and cough (11). Experiencing more ADEs reduced the odds of being adherent [low vs. medium/high: odds ratio (OR) OR1 0.77 (95% CI 0.67, 0.89), and low/medium vs. high: OR2 0.55 (05% CI 0.41, 0.73)]. Being more satisfied increased the odds of being adherent [low vs. medium/high: OR1 1.02 (95% CI 1.01, 1.03)]. Taking medication > 1 year [OR1 = 2, 0.60 (95% CI 0.43, 0.83)] and taking calcium channel blockers [OR1 = 2 0.71 (95% CI 0.54, 0.92)] decreased the odds for both low vs. medium/high and low/medium vs. high adherence.CONCLUSIONSOnly one in five patients reported perfect (high) adherence to their antihypertensive treatment regimen. Experiencing ADEs and being dissatisfied with treatment were associated with lower adherence. In addition to addressing treatment satisfaction and drug safety in first-world countries, these should also be addressed in resource-poor settings, within patient consultations, to enhance adherence.",

keywords = "adverse drug event, ambulatory patients, antihypertensive medication, generalized ordered logistic regression, hypertension, medication adherence, treatment satisfaction, HYPERTENSIVE PATIENTS, CONCISE GUIDE, PHARMACOLOGY, ASSOCIATION, VALIDATION, THERAPY, SCALE, LINK",

author = "Berhe, {Derbew Fikadu} and Katja Taxis and Haaijer-Ruskamp, {Flora M} and Afework Mulugeta and Mengistu, {Yewondwossen Tadesse} and Burgerhof, {Johannes G M} and Mol, {Peter G. M.}",

year = "2017",

month = sep,

doi = "10.1111/bcp.13312",

language = "English",

volume = "83",

pages = "2107--2117",

journal = "British Journal of Clinical Pharmacology",

issn = "0306-5251",

publisher = "Wiley",

number = "9",

}

Impact of adverse drug events and treatment satisfaction on patient adherence with antihypertensive medication - a study in ambulatory patients. / Berhe, Derbew Fikadu; Taxis, Katja ; Haaijer-Ruskamp, Flora M et al.
In: British Journal of Clinical Pharmacology, Vol. 83, No. 9, 09.2017, p. 2107-2117.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Impact of adverse drug events and treatment satisfaction on patient adherence with antihypertensive medication - a study in ambulatory patients

AU - Berhe, Derbew Fikadu

AU - Taxis, Katja

AU - Haaijer-Ruskamp, Flora M

AU - Mulugeta, Afework

AU - Mengistu, Yewondwossen Tadesse

AU - Burgerhof, Johannes G M

AU - Mol, Peter G. M.

PY - 2017/9

Y1 - 2017/9

N2 - AIMSThe aim of the present study was to evaluate the impact of adverse drug events (ADEs) and treatment satisfaction on antihypertensive medication adherence.METHODSA cross-sectional study was conducted in six public hospitals in Ethiopia. We included adult ambulatory patients on antihypertensive medication. Adherence was measured using the eight-point Morisky Medication Adherence Scale, which categorizes as low (0-5), medium (6-7) and high (8) adherence. Treatment satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM) version 1.4, which included questions about ADEs. Data were analysed using generalized ordered logistic regression with 95% confidence intervals (CIs).RESULTSWe included 925 out of 968 patients. Overall, 42% of patients scored low, 37% medium and 21% high adherence. Satisfaction with treatment was low, with a mean (standard deviation) TSQM score for global satisfaction of 51 (14). A total of 193 (21%) patients experienced 421 ADEs - mainly dyspeptic symptoms (12%), headache (11%) and cough (11). Experiencing more ADEs reduced the odds of being adherent [low vs. medium/high: odds ratio (OR) OR1 0.77 (95% CI 0.67, 0.89), and low/medium vs. high: OR2 0.55 (05% CI 0.41, 0.73)]. Being more satisfied increased the odds of being adherent [low vs. medium/high: OR1 1.02 (95% CI 1.01, 1.03)]. Taking medication > 1 year [OR1 = 2, 0.60 (95% CI 0.43, 0.83)] and taking calcium channel blockers [OR1 = 2 0.71 (95% CI 0.54, 0.92)] decreased the odds for both low vs. medium/high and low/medium vs. high adherence.CONCLUSIONSOnly one in five patients reported perfect (high) adherence to their antihypertensive treatment regimen. Experiencing ADEs and being dissatisfied with treatment were associated with lower adherence. In addition to addressing treatment satisfaction and drug safety in first-world countries, these should also be addressed in resource-poor settings, within patient consultations, to enhance adherence.

AB - AIMSThe aim of the present study was to evaluate the impact of adverse drug events (ADEs) and treatment satisfaction on antihypertensive medication adherence.METHODSA cross-sectional study was conducted in six public hospitals in Ethiopia. We included adult ambulatory patients on antihypertensive medication. Adherence was measured using the eight-point Morisky Medication Adherence Scale, which categorizes as low (0-5), medium (6-7) and high (8) adherence. Treatment satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM) version 1.4, which included questions about ADEs. Data were analysed using generalized ordered logistic regression with 95% confidence intervals (CIs).RESULTSWe included 925 out of 968 patients. Overall, 42% of patients scored low, 37% medium and 21% high adherence. Satisfaction with treatment was low, with a mean (standard deviation) TSQM score for global satisfaction of 51 (14). A total of 193 (21%) patients experienced 421 ADEs - mainly dyspeptic symptoms (12%), headache (11%) and cough (11). Experiencing more ADEs reduced the odds of being adherent [low vs. medium/high: odds ratio (OR) OR1 0.77 (95% CI 0.67, 0.89), and low/medium vs. high: OR2 0.55 (05% CI 0.41, 0.73)]. Being more satisfied increased the odds of being adherent [low vs. medium/high: OR1 1.02 (95% CI 1.01, 1.03)]. Taking medication > 1 year [OR1 = 2, 0.60 (95% CI 0.43, 0.83)] and taking calcium channel blockers [OR1 = 2 0.71 (95% CI 0.54, 0.92)] decreased the odds for both low vs. medium/high and low/medium vs. high adherence.CONCLUSIONSOnly one in five patients reported perfect (high) adherence to their antihypertensive treatment regimen. Experiencing ADEs and being dissatisfied with treatment were associated with lower adherence. In addition to addressing treatment satisfaction and drug safety in first-world countries, these should also be addressed in resource-poor settings, within patient consultations, to enhance adherence.

KW - adverse drug event

KW - ambulatory patients

KW - antihypertensive medication

KW - generalized ordered logistic regression

KW - hypertension

KW - medication adherence

KW - treatment satisfaction

KW - HYPERTENSIVE PATIENTS

KW - CONCISE GUIDE

KW - PHARMACOLOGY

KW - ASSOCIATION

KW - VALIDATION

KW - THERAPY

KW - SCALE

KW - LINK

U2 - 10.1111/bcp.13312

DO - 10.1111/bcp.13312

M3 - Article

C2 - 28429533

SN - 0306-5251

VL - 83

SP - 2107

EP - 2117

JO - British Journal of Clinical Pharmacology

JF - British Journal of Clinical Pharmacology

IS - 9

ER -