| Influence of physicians' management and communication ability on patients' persistence with antihypertensive medication. | |
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MedLine Citation:
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PMID: 20585073 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Less than 75% of people prescribed antihypertensive medication are still using treatment after 6 months. Physicians determine treatment, educate patients, manage side effects, and influence patient knowledge and motivation. Although physician communication ability likely influences persistence, little is known about the importance of medical management skills, even though these abilities can be enhanced through educational and practice interventions. The purpose of this study was to determine whether a physician's medical management and communication ability influence persistence with antihypertensive treatment. METHODS: This was a population-based study of 13,205 hypertensive patients who started antihypertensive medication prescribed by a cohort of 645 physicians entering practice in Quebec, Canada, between 1993 and 2007. Medical Council of Canada licensing examination scores were used to assess medical management and communication ability. Population-based prescription and medical services databases were used to assess starting therapy, treatment changes, comorbidity, and persistence with antihypertensive treatment in the first 6 months. RESULTS: Within 6 months after starting treatment, 2926 patients (22.2%) had discontinued all antihypertensive medication. The risk of nonpersistence was reduced for patients who were treated by physicians with better medical management (odds ratio per 2-SD increase in score, 0.74; 95% confidence interval, 0.63-0.87) and communication (0.88; 0.78-1.00) ability and with early therapy changes (odds ratio, 0.45; 95% confidence interval, 0.37-0.54), more follow-up visits, and nondiuretics as the initial choice of therapy. Medical management ability was responsible for preventing 15.8% (95% confidence interval, 7.5%-23.3%) of nonpersistence. CONCLUSION: Better clinical decision-making and data collection skills and early modifications in therapy improve persistence with antihypertensive therapy. |
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Authors:
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Robyn Tamblyn; Michal Abrahamowicz; Dale Dauphinee; Elizabeth Wenghofer; André Jacques; Daniel Klass; Sydney Smee; Tewodros Eguale; Nancy Winslade; Nadyne Girard; Ilona Bartman; David L Buckeridge; James A Hanley |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Archives of internal medicine Volume: 170 ISSN: 1538-3679 ISO Abbreviation: Arch. Intern. Med. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-29 Completed Date: 2010-07-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372440 Medline TA: Arch Intern Med Country: United States |
Other Details:
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Languages: eng Pagination: 1064-72 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, McGill University, 1140 Pine Ave W, Montreal, QC, H3A 1A3 Canada. robyn.tamblyn@mcgill.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antihypertensive Agents / therapeutic use* Communication* Decision Making Drug Prescriptions Female Follow-Up Studies Humans Hypertension / drug therapy*, psychology Male Patient Compliance / psychology* Physician's Practice Patterns / standards* Physician-Patient Relations* Prescription Drugs / therapeutic use* Prospective Studies Quebec Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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//Canadian Institutes of Health Research |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 0/Prescription Drugs |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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