Measurement of adherence to anti-hypertensive medication as perceived by doctors and patients

الملخص EN

Introduction : In the absence of objective evidence, doc¬tors frequently overestimate the level of their patient’s ad¬herence to medication and there is no published work look¬ing at what factors influence the doctor’s perceptions of medication adherence by hypertensive patients.

Therefore, the aim of this study to determine the doctor’s perceptions of adherence to antihypertensive medication and to com¬pare this with their perceptions of the clinical situation and with the patient’s self -reported medication adherence.

Methods : An English self reporting measure (7-item questionnaire) was adapted and translated to Arabic and used to determine the adherence to hypertensive medica¬tion.

Also, a 10-item questionnaire was developed to elicit the doctor’s perception of adherence (taking > 80 % of doses) and the treatment and overall condition.

This de¬scriptive study was conducted in across 2 primary health centers in Abu-Dhabi, UAE.

Results : About 40 % of them were controlled regard¬ing BP and 30 % of hypertensive patients were diabetics.

The doctors estimated adherence to be high (taking more than 80 % of doses) in 143 (71 %) of patients compared with 103(52 %) patients who reported high adherence by using Morisky score where, there was a statistically significant relationship between them.

Of the 143 subjects perceived by their doctors as having high adherence, only 64 (45 %) succeeded to achieve the target blood pressure (p < 0.001) while 55 (52 %) of the adherent patients from the self- reported point of view achieved their target BP (p < 0.001).

The doctor evaluation was not as good as expected for treatment effectiveness and quality of communication (57 % only were evaluated as good).

Only the doctor’s evaluation of the seriousness of the medical situation showed a sig¬nificant correlation with the self-reported adherence and this was in the opposite direction (gamma = - 0.32, p < 0.05).

71% of the adherent patients perceived by doctors were es-timated to have effective treatment (p < 0.0001) while 81 % of patients achieved their target BP were estimated to have effective treatment by their doctors.

Conclusion : The practical assessment of adherence and drug management would have been greatly enhanced if the results of the Arabic/English self-reporting measure had been available to the doctors in the course of routine practice.