title: Self-initiated modification of hypertension treatment in response to perceived problems.
abstract: OBJECTIVE
  To assess the prevalence of patient-initiated modification of drug instructions and the association between different classes of problems and the modification of hypertension therapy.
  
  
  METHODS
  In this cross-sectional study, all patients (n = 1215) who had been examined at a hypertension clinic during a 1-year period were surveyed. The response rate to the questionnaire was 85%. Of the 1035 respondents, 623 currently taking antihypertensive medication (self-report) were included in the study.
  
  
  RESULTS
  Of the patients taking antihypertensive drugs, 36% admitted that they had tried to manage their condition with a lower dosage and/or fewer drugs than prescribed. The percentage of patients who modified their drug regimen decreased with increasing age. One or more problems with the treatment of hypertension were reported by 79% of the respondents. The odds ratio (95% confidence interval) for modification among patients who reported 1 or more problems compared with those not reporting any problem was 3.5 (2.12 to 5.67). The prevalence of modification increased with the number of problems; this was seen in all age groups and among men and women.
  
  
  CONCLUSIONS
  Perceived problems in drug taking in the treatment of hypertension have an important impact on the prevalence of modifying drug instructions.
authors.affiliation: Department of Social Pharmacy, University of Kuopio, Finland.
authors.forename: S H
authors.initials: SH
authors.lastname: Wallenius
authors.forename: K K
authors.initials: KK
authors.lastname: Vainio
authors.forename: M J
authors.initials: MJ
authors.lastname: Korhonen
authors.forename: A G
authors.initials: AG
authors.lastname: Hartzema
authors.forename: H K
authors.initials: HK
authors.lastname: Enlund
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance
chemical_list: D000959:Antihypertensive Agents