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Gepubliceerd in: Netherlands Heart Journal 6/2008

01-06-2008 | original article

The effect of physical, social and psychological factors on drug compliance in patients with mild hypertension

Auteurs: V. S. Okken, M. G. Niemeijer, A. Dijkstra, M. W. Baars, S. Said, K. Hoogenberg, H. Orfgen, S. Otten, T. J. Cleophas

Gepubliceerd in: Netherlands Heart Journal | Uitgave 6/2008

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Abstract

Background. In patients with hypertension noncompliance with drug treatment is between 15 to 54%, and has been recognised as a relevant contributor to the burden of cardiovascular morbidity. Up to 92% of patients experience unpleasant symptoms with their condition and, particularly in these patients, the symptoms experienced may enhance compliance.
Objective. To simultaneously assess the effects of physical, social and psychological factors on noncompliance.
Methods. Patients with mild hypertension despite drug treatment, from the departments of cardiology and internal medicine, were requested to answer a self-administered questionnaire addressing the presence of physical symptoms as well as psychosocial factors. The questionnaire was based on previously used test batteries and consisted of two lists of physical complaints and four lists addressing the four domains of planned behaviour regarding medical non-adherence according to Baron and Byrne. These domains mainly assess psychosocial factors. Each list consisted of three or more items and each item was scored on fiveto seven-point scales. Mean scores were used for assessment. The lists were also separately assessed for internal consistency and reliability using Cronbach’s alphas. One-way analysis of variance and multivariate analysis of variance (MANOVA) with compliance as outcome variable and the physical, social and psychological variables as indicator variables were used for data analysis. MANOVA was adjusted for multiple testing.
Results. Many patients experienced physical symptoms due to hypertension, such as tiredness (31%), hot flushes (28%), headache (24%), reduced daily life energy (23%), palpitations (22%), with 95% confidence intervals between 16 to 38%. Scores for physical symptoms and social factors did not differ between self-reported adherers (n=165) and nonadherers (n=11). However, the score for psychological factors was significantly larger in the adherers than in the non-adherers, 5.05 versus 3.06, p<0.018. The MANOVA showed a significant overall difference between the adherers and non-adherers in the data at p<0.012, which was mainly due to the score for psychological factors. Conclusion. The effect of physical symptoms on non-compliance in mildly hypertensive patients is negligible. So is the effect of social factors. Psychological factors such as lacking a sense of guilt, regret and shame are major determinants of non-compliance. Physicians may play an educational role in improving their patients’ compliance by addressing these determinants. We should add that the conclusions should be made with reservations, given the small number of non-adherers in our sample. (Neth Heart J 2008;16:197-200.)
Literatuur
1.
go back to reference Haynes RB, Taylor DW, Sacket, DL. Compliance in health care. Baltimore: Johns Hopkins University Press, 1979. Haynes RB, Taylor DW, Sacket, DL. Compliance in health care. Baltimore: Johns Hopkins University Press, 1979.
2.
go back to reference Miller LC, Murphy R, Buss HA. Consciousness of Body: Private and Public. J Pers Soc Psychol 1981;41:397-406. Miller LC, Murphy R, Buss HA. Consciousness of Body: Private and Public. J Pers Soc Psychol 1981;41:397-406.
3.
go back to reference Lehane E, McCarthy G. An examination of intentional and unintentional aspects of medication non-adherence in patients diagnosed with hypertension. J Clin Nurs 2005;16:698-706. Lehane E, McCarthy G. An examination of intentional and unintentional aspects of medication non-adherence in patients diagnosed with hypertension. J Clin Nurs 2005;16:698-706.
4.
go back to reference Cramer JA. Consequences of Intermittent Treatment for Hypertension: The Case for Medication Compliance and Persistence. Am J Manag Care 1998;4:1563-8. Cramer JA. Consequences of Intermittent Treatment for Hypertension: The Case for Medication Compliance and Persistence. Am J Manag Care 1998;4:1563-8.
5.
go back to reference Meyer D, Leventhal H, Gutmann M. Common-Sense Models of Illness: The Example of Hypertension. Health Psychol 1985;4:115-35. Meyer D, Leventhal H, Gutmann M. Common-Sense Models of Illness: The Example of Hypertension. Health Psychol 1985;4:115-35.
6.
go back to reference Baumann LJ, Leventhal H. “I can tell when my blood pressure is up, can’t I?” Health Psychol 1985;4:203-18. Baumann LJ, Leventhal H. “I can tell when my blood pressure is up, can’t I?” Health Psychol 1985;4:203-18.
7.
go back to reference Cantillon P, Morgan M, Dundas R, Simpson J, Bartholomew J, Shaw A. Patients’ perceptions of changes in their blood pressure. J Hum Hypertens 1997;11:221-5. Cantillon P, Morgan M, Dundas R, Simpson J, Bartholomew J, Shaw A. Patients’ perceptions of changes in their blood pressure. J Hum Hypertens 1997;11:221-5.
8.
go back to reference Galton L. The silent disease: Hypertension. New York: Crown, 1974. Galton L. The silent disease: Hypertension. New York: Crown, 1974.
9.
go back to reference Fahrenberg J, Franck M, Baas U, Jost E. Awareness of blood pressure: interception or contextual judgement. J Psychosom Res 1995; 39:11-8. Fahrenberg J, Franck M, Baas U, Jost E. Awareness of blood pressure: interception or contextual judgement. J Psychosom Res 1995; 39:11-8.
10.
go back to reference Brondolo E, Rosen RC, Kostis JB, Schwartz JE. Relationship of Physical Symptoms and Mood to Perceived and Actual Blood Pressure in Hypertensive Men: A Repeated Measures Design. Psychosom Med 1999;61:211-8. Brondolo E, Rosen RC, Kostis JB, Schwartz JE. Relationship of Physical Symptoms and Mood to Perceived and Actual Blood Pressure in Hypertensive Men: A Repeated Measures Design. Psychosom Med 1999;61:211-8.
11.
go back to reference Lau RR, Bernard TM, Hartman KA. Further explorations of common-sense representations of common illnesses. Health Psychol 1989;8:195-219. Lau RR, Bernard TM, Hartman KA. Further explorations of common-sense representations of common illnesses. Health Psychol 1989;8:195-219.
12.
go back to reference Baron RA, Byrne D. Social Psychology. Boston: Pearson, Allyn and Bacon, 2000. Baron RA, Byrne D. Social Psychology. Boston: Pearson, Allyn and Bacon, 2000.
Metagegevens
Titel
The effect of physical, social and psychological factors on drug compliance in patients with mild hypertension
Auteurs
V. S. Okken
M. G. Niemeijer
A. Dijkstra
M. W. Baars
S. Said
K. Hoogenberg
H. Orfgen
S. Otten
T. J. Cleophas
Publicatiedatum
01-06-2008
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 6/2008
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/BF03086145

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