The number of health professionals available, especially the number of doctors, significantly influences the degree of control of hypertension, along with national health expenditure.
This is one of the conclusions of a study by researcher Paulo Santos from CINTESIS – Center for Health Technology and Services Research and professor of the Faculty of Medicine of the University of Porto (FMUP), and Ana Sofia Carvalho from FMUP.
The study, entitled “Medical Adherence in Patients with Arterial Hypertension: The Relationship with Healthcare Systems’ Organizational Factors,” assessed adherence to treatment of patients with hypertension in 31 different countries, including Portugal, and found that only 55% of patients take medicines as prescribed by the doctor. However, adherence has been found to vary widely worldwide, from only 11% in Indonesia to 85% in Australia.
Among the reasons that could interfere with adherence, the determinants related to the organization of health systems were studied, namely the number of health professionals (doctors, nurses, and pharmacists), consultation time, and health expenses.
“We found that the number of existing health professionals and public and total investment in health are determinants of greater adherence to therapy,” reveals the study, published in the scientific journal Patient Preference and Adherence.
In this context, the number of doctors emerges as the most “predominant” organizational factor in adherence to therapy. “We think that more doctors facilitate access to health care as well as closer follow-up, contributing to greater involvement of patients in their treatment,” the researchers explain.
Also, the number of nurses has been shown to have a positive relationship with adherence since they play an essential role in blood pressure control and patient education. On the other hand, the number of pharmacists did not appear to play a significant role at this level, leaving room for improvement for their intervention in this problem. Interestingly, there was no evidence of a relationship between the duration of the consultation and the degree of adherence to therapy in hypertensive patients. On the other hand, adherence appears positively associated with health investment.
“It is not enough to prescribe more medicines: It is important to understand why patients do not adhere to treatments and reduce nonadherence by finding the best strategy for each individual. This study focuses on the factors related to the organization and structure of health services, drawing attention to the responsibility of promoting conditions that maximize people’s health potential”, say the authors.
Hypertension is the leading determinant of mortality worldwide, estimated to contribute to about 7.5 million deaths per year. The World Health Organization (WHO) defines hypertension with blood pressure values equal to or greater than 140/90 mm Hg and estimates that the disease affects about 22% of the adult population. In Portugal, a recent study shows that 42% of adults live with this condition.