Document Detail

Changes in antihypertensive therapy--the role of adverse effects and compliance.
MedLine Citation:
PMID:  10321445     Owner:  NLM     Status:  MEDLINE    
In a German multicentre study (1603 patients, 320 private practices), adverse effects and patient compliance during antihypertensive therapy were investigated using standardized questionnaires for both patient and physician. Patients with a change in antihypertensive therapy during the last six months were included in this study. The single most important reason for the change in therapy was inadequate blood pressure control (48.4%), followed by adverse effects (30.1%), patient dissatisfaction (20.0%), non-compliance (16.8%) and cost (4.9%). The most frequent adverse effects noted by the doctors were cough (51.9%), oedema (36.9%), flush (36.6) and dizziness (27.8%). In comparing the answers of the physicians and patients, it becomes obvious that compliance may be overestimated by the doctors (good: 41.7%; medium: 57.3%; bad: 1.0%), since only 32.3% of the patients stated that they never missed a dose, 54.8% were occasionally non-compliant and 12.9% admitted missing a dose frequently. The predominant reasons for non-compliance (assessed by the patients) were forgetfulness (40.4%), followed by adverse effects (9.6%) and irregular lifestyle (6.5%). Thus, lack of effectiveness and adverse effects/patient dissatisfaction/non-compliance contributed roughly equally to the decision to change therapy. In addition, forgetfulness was shown to be an important contributor to suboptimal compliance. Lastly, physicians may still underestimate the extent of non-compliance.
R Düsing; B Weisser; T Mengden; H Vetter
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Blood pressure     Volume:  7     ISSN:  0803-7051     ISO Abbreviation:  Blood Press.     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1999-07-02     Completed Date:  1999-07-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9301454     Medline TA:  Blood Press     Country:  NORWAY    
Other Details:
Languages:  eng     Pagination:  313-5     Citation Subset:  IM    
Medizinische Universitäts-Poliklinik, Bonn, Germany.
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MeSH Terms
Aged, 80 and over
Antihypertensive Agents / adverse effects*,  economics,  therapeutic use*
Drug Costs
Hypertension / drug therapy*
Middle Aged
Patient Compliance*
Patient Satisfaction
Treatment Refusal
Reg. No./Substance:
0/Antihypertensive Agents

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