Barriers to effective outpatient hypertension treatment: a view of physicians and patients

Aim. To study the opinion of primary care physicians and hypertensive (HTN) outpatients with different compliance rate on factors preventing effective antihypertensive therapy (AHT).Material and methods. Primary care physicians and HTN outpatients were questioned. Questionnaires for physicians and p...

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Main Authors: S. V. Nedogoda, A. V. Sabanov, O. I. Bychkova
Format: Article
Language:Russian
Published: «FIRMA «SILICEA» LLC 2020-05-01
Series:Российский кардиологический журнал
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Online Access:https://russjcardiol.elpub.ru/jour/article/view/3776
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author S. V. Nedogoda
A. V. Sabanov
O. I. Bychkova
author_facet S. V. Nedogoda
A. V. Sabanov
O. I. Bychkova
author_sort S. V. Nedogoda
collection DOAJ
description Aim. To study the opinion of primary care physicians and hypertensive (HTN) outpatients with different compliance rate on factors preventing effective antihypertensive therapy (AHT).Material and methods. Primary care physicians and HTN outpatients were questioned. Questionnaires for physicians and patients included informative and survey parts, with a list of possible factors aggravated adherence to treatment. The assessment was carried out using visual analogue scale. The patient questionnaire also included questions about AHT and the eight-item Morisky Medication Adherence Scale (MMAS-8). The calculation was carried out with a 95% confidence interval (CI).Results. The survey involved 298 physicians and 517 patients. Among patients, about 1% had a high compliance rate, 34% — moderate, 65% — low. In all groups, AHT did not significantly differ and was characterized by a low frequency of prescribing fixeddose combinations (27,1%). According to physicians, the most significant and equivalent are the economic aspects of treatment — 7,9±2,1 (95% CI: 7,51-8,38), the need for lifestyle change — 7,9±2,4 (95% CI: 7,37-8,38) and, to a slightly lesser extent, psychological aspects 6,8±2,2 (95% CI: 5,43-6,43). The economic aspects of treatment and need for lifestyle change were also most significant factors according to patients with high (8,8±1,8 (95% CI: 7,23-10,37) and 8,4±1,7 (95% CI: 6,93-9,87), respectively) and low (95% CI: 6,4±3,0 (5,65-7,07) and 6,2±2,8 (95% CI: 5,5-6,82) respectively) compliance rates. For patients with moderate compliance rate, the most significant and almost equivalent factors were the need for lifestyle change — 5,6±3,3 (95% CI: 4,53- 6,71), the need for regular visits — 5,6±3,1 (95% CI: 4,53-6,58) and the need for selfmanagement — 5,6±2,8 (95% CI: 4,63-6,48).Conclusion. The results obtained make it possible to forecast the compliance rate of patients with HTN, and, therefore, direct more efforts to those with a low rate, thereby increasing the effectiveness of AHT.
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spelling doaj-art-32da9525da4f4eb4aed6f725faa6198c2025-08-20T02:59:06Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202020-05-0125410.15829/1560-4071-2020-37762875Barriers to effective outpatient hypertension treatment: a view of physicians and patientsS. V. Nedogoda0A. V. Sabanov1O. I. Bychkova2Volgograd State Medical UniversityVolgograd State Medical UniversityMilitary Medical Service of Volgograd Region Federal Security ServiceAim. To study the opinion of primary care physicians and hypertensive (HTN) outpatients with different compliance rate on factors preventing effective antihypertensive therapy (AHT).Material and methods. Primary care physicians and HTN outpatients were questioned. Questionnaires for physicians and patients included informative and survey parts, with a list of possible factors aggravated adherence to treatment. The assessment was carried out using visual analogue scale. The patient questionnaire also included questions about AHT and the eight-item Morisky Medication Adherence Scale (MMAS-8). The calculation was carried out with a 95% confidence interval (CI).Results. The survey involved 298 physicians and 517 patients. Among patients, about 1% had a high compliance rate, 34% — moderate, 65% — low. In all groups, AHT did not significantly differ and was characterized by a low frequency of prescribing fixeddose combinations (27,1%). According to physicians, the most significant and equivalent are the economic aspects of treatment — 7,9±2,1 (95% CI: 7,51-8,38), the need for lifestyle change — 7,9±2,4 (95% CI: 7,37-8,38) and, to a slightly lesser extent, psychological aspects 6,8±2,2 (95% CI: 5,43-6,43). The economic aspects of treatment and need for lifestyle change were also most significant factors according to patients with high (8,8±1,8 (95% CI: 7,23-10,37) and 8,4±1,7 (95% CI: 6,93-9,87), respectively) and low (95% CI: 6,4±3,0 (5,65-7,07) and 6,2±2,8 (95% CI: 5,5-6,82) respectively) compliance rates. For patients with moderate compliance rate, the most significant and almost equivalent factors were the need for lifestyle change — 5,6±3,3 (95% CI: 4,53- 6,71), the need for regular visits — 5,6±3,1 (95% CI: 4,53-6,58) and the need for selfmanagement — 5,6±2,8 (95% CI: 4,63-6,48).Conclusion. The results obtained make it possible to forecast the compliance rate of patients with HTN, and, therefore, direct more efforts to those with a low rate, thereby increasing the effectiveness of AHT.https://russjcardiol.elpub.ru/jour/article/view/3776hypertensionantihypertensive therapyadherence to treatmentquestionnaireeconomic aspects of therapy
spellingShingle S. V. Nedogoda
A. V. Sabanov
O. I. Bychkova
Barriers to effective outpatient hypertension treatment: a view of physicians and patients
Российский кардиологический журнал
hypertension
antihypertensive therapy
adherence to treatment
questionnaire
economic aspects of therapy
title Barriers to effective outpatient hypertension treatment: a view of physicians and patients
title_full Barriers to effective outpatient hypertension treatment: a view of physicians and patients
title_fullStr Barriers to effective outpatient hypertension treatment: a view of physicians and patients
title_full_unstemmed Barriers to effective outpatient hypertension treatment: a view of physicians and patients
title_short Barriers to effective outpatient hypertension treatment: a view of physicians and patients
title_sort barriers to effective outpatient hypertension treatment a view of physicians and patients
topic hypertension
antihypertensive therapy
adherence to treatment
questionnaire
economic aspects of therapy
url https://russjcardiol.elpub.ru/jour/article/view/3776
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AT avsabanov barrierstoeffectiveoutpatienthypertensiontreatmentaviewofphysiciansandpatients
AT oibychkova barrierstoeffectiveoutpatienthypertensiontreatmentaviewofphysiciansandpatients