Validity of four indirect methods to measure adherence in primary care hypertensives

被引：0
作者：
J C Prado
E Kupek
D Mion
机构：
[1] CCS/UFSC,Department of Public Health
[2] Campus Universitário,Department of Public Health – CCS/UFSC
[3] Trindade,Department of Nephrology
[4] Florianópolis,undefined
[5] Santa Catarina,undefined
[6] Brazil,undefined
[7] Federal University at Santa Catarina,undefined
[8] Campus Universitário,undefined
[9] Trindade,undefined
[10] Florianópolis,undefined
[11] Santa Catarina,undefined
[12] Brazil,undefined
[13] Hypertension Unit,undefined
[14] Clinic Hospital,undefined
[15] University of São Paulo,undefined
[16] School of Medicine,undefined
[17] University of São Paulo,undefined
[18] Municipal Secretary of Health,undefined
来源：
Journal of Human Hypertension | 2007年 / 21卷
关键词：
adherence; validity; indirect methods; primary care;
D O I：
暂无
中图分类号：
学科分类号：
摘要：
High blood pressure (HBP) is one of the most important risk factors for morbidity and mortality in the world. Non-adherence to medication is associated with the lack of control of HBP. The objective of this study was to assess the validity of four indirect methods for measuring adherence to medication to control HBP in primary health care. A random sample of 120 hypertensive patients who were undergoing treatment for at least 2 months in a primary care unit in Florianópolis (Brazil) were included in the study. The independent variables were four indirect methods to measure adherence to medication: knowledge regarding the HBP medication, the blood pressure level, attitude regarding the medication intake (Morisky–Green test) and self-reported adherence. The classification of HBP was based on criteria established by the Brazilian Ministry of Health. The gold standard used for measuring adherence was the pill count. Logistic regression was used to estimate sensitivity (highest value of 88.2% for self-report), specificity (highest value of 70.7% for HBP control), positive predictive value (highest value of 46.4% for HBP control) and negative predictive value (highest value of 79.1% for Morisky–Green test) for each of the indirect methods. No indirect method of measuring adherence had a good positive predictive value for adherence, which was best predicted by patients' age and whether they managed to control HBP. The results also revealed low treatment adherence (31.2%) and low control of HBP (37.6%). Non-adherence was mainly associated with side effects of the treatment.
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页码：579 / 584
页数：5
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