Are you taking your Meds?

How many of us can attest to incompliance with a physician’s instructions regarding treatments of infections or prevention of disease?  I am sure many of you are just as guilty as I am.  I found an interesting article that relates to hypertension, and medication nonadherence.  Medication nonadherence “is where adherence is defined as the extent to which a person’s behavior corresponds with the recommendations of their health care provider” (Pladevall & Brotons).

Most of us are knowledgeable about hypertension; however, I am going to provide some background of this disease. Approximately 50 million people in the USA  have high blood pressure.  Hypertension is a substantial problem both in terms of its prevalence and the severity of its consequences.  Variation exists between age, gender, race, and ethnicity.  Hypertension increases ones risk of developing cardiovascular disease, stroke, and renal disease.  Hypertension has become a public health concern as cardiovascular disease and stroke is the first and third leading causes of death especially in America. 

The pathological mechanism involves elevation of the blood pressure.  High pressures within the vasculature system stimulate hypertrophy of smooth muscle cells and injury to endothelium, which results in atherosclerosis.

Treatment to prevent hypertension involves lifestyle modifications such as weight reduction, alcohol limitation, aerobic exercise, limitation to sodium intake, maintenance of calcium, potassium, and magnesium intake, stress management and medications. In promote adherence to these treatments, the study focused on using techniques to ensure compliance.  The physicians allowed intervention groups to count patients pills, designated a relative for support, and handed out educational information. 

The outcome of providing intervention caused blood pressure control for up to 2.5 years, but sadly this did not improve long-term cardiovascular problems.  The study did show that multifactorial interventions are key helpers in improving adherence to antihypertensive medication, and increasing the effectiveness adherence and blood pressure management.

Reference

Pladevall, M; Brotons, C; and Rafael, G. (2010). Multicenter Cluster-Randomized Trial of a Multifactorial Intervention to Improve Antihpertensive Medication Adherence and Blood Pressure Control Among Patients at High Cardiovascula Risk (The OM99 Study). American Heart Associations. DOI: 10.1161/CIRCULAIONAHA.109.892778/DC1.

Talbert, L. R.; Dipiro T. J.; Yee, C. G. (2011). Pharmacotherapy: A Pathophysiologic Approach. New York, NY. McGraw Hill Medical.