Treatment adherence among adult hypertensive patients: a cross-sectional retrospective study in primary care in Romania

• Published in: Patient preference and adherence Vol. 12; pp. 625 - 635
• Main Authors: Tilea, Ioan, Petra, Dorina, Voidazan, Septimiu, Ardeleanu, Elena, Varga, Andreea
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2018; Dove Medical Press
• Subjects: Adults; Antihypertensive agents; blood pressure; Care and treatment; Chronic kidney failure; Combination drug therapy; Diseases; Eastern Europe; Family medicine; Hypertension; Kidney diseases; Male identity; Medical records; Original Research; Patient compliance; prescription; Risk factors; Setting (Literature); Strategic planning (Business); Romania; blood pressure; family medicine; Eastern Europe; prescription; hypertension
• ISSN: 1177-889X; 1177-889X
• DOI: 10.2147/PPA.S162965

This study was performed to elucidate the level of adherence to antihypertensive treatment in adult subjects attending a family medicine clinic in a city in central Romania. A cross-sectional, retrospective study was performed on a cohort of hypertensive adults. A total of 525 participants were selected from 1,714 adults attending a single urban family medicine practice. Assessment of adherence to therapy was performed by a chart review of prescription and clinical records over a 4-year study period. The results showed that 69.8% of the patients had high adherence (>80% with therapy); 20.3% had medium adherence (20%-79%); and 9.9% had low adherence (<20%). A positive association was found ( = 0.01) between low adherence and male gender. A significant positive association ( = 0.02) was found between total cardiovascular risk and level of adherence. We found that 54.7% of the high adherence subjects had well-controlled blood pressure, and chronic kidney disease was associated with high adherence to therapy ( = 0.03). Antihypertensive regimens administered as fixed-dose combinations were positively associated with high adherence ( = 0.001). Subjects who had their antihypertensive regimen adjusted to a new drug class during the study period showed enhanced adherence compared to subjects treated with an unchanged regimen ( = 0.001). This is the first published study assessing adherence to antihypertensive therapy in family medicine practice in Romania. It presented data derived from a primarily urban setting and targeted a geographical area where the prevalence of hypertension has increased continuously. Female gender, age, presence of cardiovascular risk factors, defined cardiovascular disease, chronic renal impairment, and good control of hypertension were positively associated with high adherence. The results provide insights to guide further strategies to improve adherence and indirect methods for blood pressure management strategies.