Bags filled with pill boxes, side effects, insufficient access to health care or medicines, reduced consultation time, illnesses such as depression, inadequate follow-up and poor adherence to therapy: these are some of the key factors for the lack of control of hypertension, the most important cardiovascular risk factor in Portugal and worldwide.
These aspects related to adherence to therapy are pointed out by Ana Correia Oliveira and Paulo Santos, researcher at CINTESIS – Center for Health Technology and Services Research in a study recently published in the Journal of Hypertension and Management.
The objective of the research study was to critically review the main determinants that interfere with non-adherence to therapy, as well as possible strategies to control hypertension, a problem that affects 42.2% of the Portuguese population over 18 years of age (44.4% of men and 40.2% of women) and 31% of the world population.
For the CINTESIS researcher, “clinicians play an important role in non-adherence,” for example, “when they prescribe complex schemes with multiple medications, when they do not fully explain their benefits and risks [such as fatigue, headaches, edema, cough, increased urinary frequency, metabolic changes and sexual dysfunction] and when they do not take into account the costs for the patients.”
Paulo Santos indicates several measures that can improve the control of blood pressure, how to use fixed associations (one or more active principles in a single pill) and to simplify the therapeutic schemes.
In this context, it is essential to “negotiate the best options and to establish a good communication channel with patients, sharing information in real time”. In this regard, the researcher draws attention to the importance of increasing the health literacy of our population.
According to the specialist in General and Family Medicine, “the evidence shows that 25% of the patients do not buy the drugs prescribed by their doctor and 10% forget to take them daily.” In addition, “one-third of the patients discontinue treatment after six months and half after one year.”
In total, more than 45% of the patients do not adhere to the medication. In patients with uncontrolled hypertension, this percentage exceeds 83%. Men, younger patients and those who have depression and heart disease are the ones who failed the most in following treatment.