Measuring Adherence in Hypertensive Patients—Pilot Study with Self-Efficacy for Appropriate Medication Use Scale in Bulgaria

<i>Background and Objectives</i>: Hypertension is found as the leading cardiovascular disease in Bulgaria and the most frequent lifelong condition with a high risk of non-adherence. The aim of this study is to assess the hypertension patients’ adherence to medication therapy in Bulgaria...

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Main Authors: Zornitsa Mitkova, Elena Dimitrova, Velislava Kazakova, Nikolay Gerasimov, Diyan Gospodinov, Javor Mitkov, Stamen Pishev, Guenka Petrova
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/3/478
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author Zornitsa Mitkova
Elena Dimitrova
Velislava Kazakova
Nikolay Gerasimov
Diyan Gospodinov
Javor Mitkov
Stamen Pishev
Guenka Petrova
author_facet Zornitsa Mitkova
Elena Dimitrova
Velislava Kazakova
Nikolay Gerasimov
Diyan Gospodinov
Javor Mitkov
Stamen Pishev
Guenka Petrova
author_sort Zornitsa Mitkova
collection DOAJ
description <i>Background and Objectives</i>: Hypertension is found as the leading cardiovascular disease in Bulgaria and the most frequent lifelong condition with a high risk of non-adherence. The aim of this study is to assess the hypertension patients’ adherence to medication therapy in Bulgaria by using the self-efficacy for appropriate medication use scale (SEAMS). <i>Materials and Methods</i>: A cross-sectional study was conducted in the major cardiology settings in the capital Sofia and in Burgas, the fourth largest city in Bulgaria. Data were collected from January 2024 to July 2024. The SEAMS was validated in Bulgarian in a sample of patients with hypertension that made it extremely suitable for our study. We applied 19 questions. Additionally, we used Cronbach’s α, ANOVA analysis, Pearson correlation, and covariance tests for statistical significance. <i>Results</i>: A total of 232 patients completed the study. Both genders are almost equally distributed (49.6% male and 50.4% female). The results reveal that the increase in the number of diseases and prescribed medicinal products leads to a worsening adherence level. Advancing age negatively affects the adherence scores. The study showed that in half of the age groups studied (patients’ age: 40–49, 60–69, and 70–79), adherence in patients treated with FDCs was better or almost the same (patients’ age: 50–59) as those treated with several mono-products. <i>Conclusions</i>: Measuring adherence with SEAMS in the hypertensive Bulgarian population in two regions reveals a good level of adherence. Factors negatively affecting adherence were older age, polypharmacy, co-morbidity, and therapy with monoproducts.
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spelling doaj-art-4c787022ae4f45e89f7e2d1cfbc503792025-08-20T01:49:00ZengMDPI AGMedicina1010-660X1648-91442025-03-0161347810.3390/medicina61030478Measuring Adherence in Hypertensive Patients—Pilot Study with Self-Efficacy for Appropriate Medication Use Scale in BulgariaZornitsa Mitkova0Elena Dimitrova1Velislava Kazakova2Nikolay Gerasimov3Diyan Gospodinov4Javor Mitkov5Stamen Pishev6Guenka Petrova7Department of Organization and Economy of Pharmacy, Faculty of Pharmacy, Medical University Sofia, 1000 Sofia, BulgariaNational Cardiology Hospital Sofia, 1309 Sofia, BulgariaDepartment of Organization and Economy of Pharmacy, Faculty of Pharmacy, Medical University Sofia, 1000 Sofia, BulgariaMedical College, Trakia University, 6000 Stara Zagora, BulgariaMedical Center “Staykov” Burgas, 8000 Burgas, BulgariaDepartment of Pharmaceutical Chemistry, Faculty of Pharmacy, Medical University Sofia, 1000 Sofia, BulgariaDiagnostic-Consulting Center I-Burgas, 8000 Burgas, BulgariaDepartment of Organization and Economy of Pharmacy, Faculty of Pharmacy, Medical University Sofia, 1000 Sofia, Bulgaria<i>Background and Objectives</i>: Hypertension is found as the leading cardiovascular disease in Bulgaria and the most frequent lifelong condition with a high risk of non-adherence. The aim of this study is to assess the hypertension patients’ adherence to medication therapy in Bulgaria by using the self-efficacy for appropriate medication use scale (SEAMS). <i>Materials and Methods</i>: A cross-sectional study was conducted in the major cardiology settings in the capital Sofia and in Burgas, the fourth largest city in Bulgaria. Data were collected from January 2024 to July 2024. The SEAMS was validated in Bulgarian in a sample of patients with hypertension that made it extremely suitable for our study. We applied 19 questions. Additionally, we used Cronbach’s α, ANOVA analysis, Pearson correlation, and covariance tests for statistical significance. <i>Results</i>: A total of 232 patients completed the study. Both genders are almost equally distributed (49.6% male and 50.4% female). The results reveal that the increase in the number of diseases and prescribed medicinal products leads to a worsening adherence level. Advancing age negatively affects the adherence scores. The study showed that in half of the age groups studied (patients’ age: 40–49, 60–69, and 70–79), adherence in patients treated with FDCs was better or almost the same (patients’ age: 50–59) as those treated with several mono-products. <i>Conclusions</i>: Measuring adherence with SEAMS in the hypertensive Bulgarian population in two regions reveals a good level of adherence. Factors negatively affecting adherence were older age, polypharmacy, co-morbidity, and therapy with monoproducts.https://www.mdpi.com/1648-9144/61/3/478adherencehypertensionBulgarian patientsSEAMS
spellingShingle Zornitsa Mitkova
Elena Dimitrova
Velislava Kazakova
Nikolay Gerasimov
Diyan Gospodinov
Javor Mitkov
Stamen Pishev
Guenka Petrova
Measuring Adherence in Hypertensive Patients—Pilot Study with Self-Efficacy for Appropriate Medication Use Scale in Bulgaria
Medicina
adherence
hypertension
Bulgarian patients
SEAMS
title Measuring Adherence in Hypertensive Patients—Pilot Study with Self-Efficacy for Appropriate Medication Use Scale in Bulgaria
title_full Measuring Adherence in Hypertensive Patients—Pilot Study with Self-Efficacy for Appropriate Medication Use Scale in Bulgaria
title_fullStr Measuring Adherence in Hypertensive Patients—Pilot Study with Self-Efficacy for Appropriate Medication Use Scale in Bulgaria
title_full_unstemmed Measuring Adherence in Hypertensive Patients—Pilot Study with Self-Efficacy for Appropriate Medication Use Scale in Bulgaria
title_short Measuring Adherence in Hypertensive Patients—Pilot Study with Self-Efficacy for Appropriate Medication Use Scale in Bulgaria
title_sort measuring adherence in hypertensive patients pilot study with self efficacy for appropriate medication use scale in bulgaria
topic adherence
hypertension
Bulgarian patients
SEAMS
url https://www.mdpi.com/1648-9144/61/3/478
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