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Adherence to pharmacological and non-pharmacological treatment of frail hypertensive patients

Journal of Geriatric Cardiology 2018年第2期15卷 153-161页

作者： Beata Jankowska-Polanska Karolina Zameta Izabella Uchmanowicz Anna Szymanska-Chabowska donald morisky Grzegorz Mazur Department of Clinical Nursing Wroclaw Medical University Wroclaw Poland Department of lnternal Medicine Occupational Diseases Hypertension and Oncology Wroclaw Medical University Wroclaw Poland Department of Community Health Sciences UCLA Fielding School of Public Health Los Angeles USA

Objective To investigate the relationship between frailty syndrome （FS） and adherence to pharmacological and non-pharmacological treatment for hypertension. Methods The study included 100 patients diagnosed with hypertension and treated with one or more hypotensive drugs. Results Frail patients obtained low scores （4.1 ± 2.0） for adherence to pharmaceutical treatment of hypertension, while non-frail patients obtained moderate scores （6.1 ± 2.1）. Non-frail patients had higher scores in two out of four domains of the Health Behavior Inventory （HBI）： positive mental attitudes （3.6 ± 0.4 vs. 3.2 ± 0.5; P = 0.006） and health practices （3.6 ± 0.5 vs. 3.2 ± 0.5; P 〈 0.03）; as well as higher global scores （HBI raw score）： 83.3 ±10.6 vs. 77.3 ± 9.5; P 〈 0.03. Multiple regression analysis showed that frailty syndrome （FS） was a statistically significant independent determinant of worse adherence to pharmacological treatment （β= -0.27; P 〈 0.001） and health behaviors （β = -0.10; P = 0.036）. Education was a statistically significant independent determinant of better adherence to pharmacological treatment （β = 0.82; P = 0.012）, while net income positively affected health behaviors as measured by the HBI （β = 0.39; P = 0.046）. Conclusions FS is a significant independent factor contributing to worse adherence to pharmacological and non-pharmacological treatment of hypertension. Better education significantly improves patients＇ adherence to the prescribed pharmacological treatment, while a good financial standing evidenced by high net income is a determinant of better adherence to health-related behaviors recommended in hypertension treatment.

关键词： Adherence Elderly Frailty syndrome Non-pharmacological treatment

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Validation of the 8-Item morisky Medication Adherence Scale in Chronically Ill Ambulatory Patients in Rural Greece

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Open Journal of Nursing 2016年第3期6卷 158-169页

作者： Sotirios Plakas Dimos Mastrogiannis Marianna Mantzorou Theodoula Adamakidou Georgia Fouka Angeliki Bouziou Chrysoula Tsiou donald E. morisky Department of Nursing Technological Educational Institution (TEI) of Athens Athens Greece Research Unit for Nursing Rehabilitation of the Chronically Ill Technological Educational Institution (TEI) of Athens Athens Greece Department of Nursing Technological Educational Institute of Central Greece Lamia Greece General Hospital of Aitoloakarnania Agrinion Greece Department of Community Health Sciences UCLA Fielding School of Public Health Los Angeles CA USA

Objective: To validate a Greek version of the structured self-reported 8-item morisky Medication Adherence Scale (MMAS-8) and determine its psychometric properties in patients with chronic illnesses. Methods: A cross-sectional survey was conducted in a small public hospital and a public health care centre, in a rural town in western Greece. The sample consisted of 100 patients with various chronic illnesses. Data were collected between January-May 2011, on the Greek version of the MMAS-8 and Beliefs about Medicines Questionnaire (BMQ). Results: Scale’s reliability analysis revealed an overall Cronbach’s alpha of 0.753 and the corrected item to total correlations, were greater than 0.30 for each of the 8 items comprising the medication adherence scale, showing good internal consistency. Convergent validity was supported by a significant correlation between the present scale’s total score and the BMQ-Specific Necessity score (Spearman’s rho = 0.492, p < 0.001). Conclusion: The current study showed acceptable reliability and validity of the Greek version of the 8-item MMAS to measure adherence to medications for various chronic illnesses. The validated Greek version of the MMAS-8 can help towards understanding adherence barriers in Greece so as to develop effective strategies to increase adherence and reduce the costs.

关键词： Adherence Validation Chronic Illnesses morisky MMAS-8 Scale

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