Antihypertensive treatment adherence in workers of a General Hospital

cross-sectional research, consisting of 108 workers who self-reported as being hypertensive. Associations between sociodemographic, work and health variables were assessed regarding adherence.

Results:

the mean age was 44.2 years, with predominance of the female sex and workers from the nursing area. Through blood pressure measurement, 25% of participants were classified as non-controlled hypertensive patients. Approximately 88% reported taking some sort of medication; however, 79.6% did not adhere to the antihypertensive treatment. In the multiple regression analysis, the independent factors for non-adherence were hypercholesterolemia (OR=8.10; p=0.024) and missing medical appointments (OR=4.06; p=0.048).

Conclusion:

we verified a significant percentage of non-adherence. Since hypertension and cholesterol are asymptomatic diseases that require continuous treatment, hypertensive patients have difficulties to understand the importance of adhering to the treatment, even being health professionals or working in hospitals.

Descriptors:
Hypertension; Medication Adherence; Occupational Health; Blood Pressure; Drug Therapy

Variable	Category	n	(%)
Sex	Male	26	(24.1)
	Female	82	(75.9)
Ethnicity^* * some values were ignored.	White	70	(66.7)
	Black	16	(15.2)
	Others	19	(18.1)
Marital status^* * some values were ignored.	Single	22	(20.8)
	Married	57	(53.8)
	Others	27	(25.3)
Healthcare professional	No	51	(47.2)
	Yes	57	(52.8)
Occupation	Nurse technician	24	(22.2)
	Governance assistant	20	(18.5)
	Nursing assistant	12	(11.1)
	Nurse	9	(8.3)
	Physician	6	(5.6)
	Others	37	(34.3)
Place of work	Hygiene and hospitality	23	(21.3)
	Emergency room	11	(10.2)
	Medical clinic	8	(7.4)
	Others	66	(61.1)
Hours worked/day^* * some values were ignored.	< 6	1	(0.9)
	6 to 8	20	(18.9)
	8 to 10	34	(32.1)
	> 10	51	(48.1)
Take a vacation every year?	No	9	(8.3)
	Yes	99	(91.7)
Use vacations to rest?	No	19	(17.6)
	Yes	89	(82.4)
Other professional activities	No	74	(68.5)
	Yes	34	(31.5)
Work weekends?	No	27	(25.5)
	Yes	79	(74.5)
Feeling regarding professional life	Very satisfied	33	(30.6)
Feeling regarding professional life	Could improve	66	(61.1)
	Not satisfied	8	(7.4)
	Completely dissatisfied	1	(0.9)
Relationship with co-workers^* * some values were ignored.	Poor	1	(1.0)
Relationship with co-workers^* * some values were ignored.	Average	7	(6.9)
	Good	70	(68.6)
	Very good	24	(23.5)
Self-assessment of health	Great	4	(3.7)
	Good	39	(36.1)
	Average	55	(50.9)
	Poor	10	(9.3)
Take some medication^* * some values were ignored.	No	13	(12.1)
	Yes	94	(87.9)
Total		108	(100.0)

Variables^* * 7 cases do not apply and 8 were ignored.	Category	n	(%)
Adherence to Morisky and Green	Adherence	19	(20.4)
	Non-adherence	74	(79.6)
Have you ever forgotten to take your medication?	No	35	(37.6)
Have you ever forgotten to take your medication?	Yes	58	(62.4)
Are you sometimes careless about the time you should take your medication?	No	36	(38.7)
	Yes	57	(61.3)
When you are feeling well, have you ever not taken your medication?	No	67	(72.0)
	Yes	26	(28.0)
When you feel unwell due to the medication, have you ever not taken it?	No	60	(64.5)
	Yes	33	(35.5)
Total		93	(100.0)

Variable	Morisky and Green	Blood Pressure (mmHg)
		< 140x90		≥ 140x90		p ^* * Fisher’s Exact Test
			(%)	n	(%)
	Adherence	19	(100.0)	0	(0.0)	0.002
	Non-adherence	50	(67.6)	24	(32.4)
Total		69	(74.2)	24	(25.8)

Variables	Morisky and Green
	Adherence	Non-adherence	p (X²)	OR^* * the group < 140x90 was used as reference category.	CI_95%	p
	n (%)	n (%)
Have you ever interrupted your blood pressure treatment?
No	16 (28.1)	41 (71.9)	0.021	1.0	1.15 – 16.0
Yes	3 (8.3)	33 (91.7)		4.29		0.030
Have you ever missed an appointment with your physician?
No	12 (32.4)	25 (67.6)	0.020	1.0	1.18 – 9.59
Yes	7 (12.5)	49 (87.5)		3.36		0.024

Variable	Category	OR_adjusted	CI_95%	p
Hypercholesterolemia
	No	1.0	1.32 – 49.90	0.024
	Yes	8.10
Have you ever missed an appointment with your physician?
	No	1.0	1.01 – 16.26	0.048
	Yes	4.06

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[1] CORRESPONDING AUTHOR: Fernanda Amendola. E-mail: fernanda_amendola@yahoo.com.br