What effects do patients feel from their antihypertensive tablets and how do they react to them? Qualitative analysis of interviews with patients.
BACKGROUND
Patients commonly experience palpable effects from antihypertensives. Few studies have examined patients' experiences of these effects and how they influence patients' behaviour and medicine-taking.


OBJECTIVE
To describe the palpable effects that patients attribute to their antihypertensive tablets and the ways that they react to them.


METHODS
In depth interviews with a maximum variety sample of 38 patients taking antihypertensive medication in 2 mainly urban UK general practices. Qualitative analysis based upon the study's objectives.


RESULTS
Most patients attributed palpable effects to their antihypertensives. Some effects were welcome, attributed to lowered blood pressure or a calming effect of tablets, but others were unwelcome. As a result of these, some patients stopped their tablets, but more continued taking tablets as usual, took their tablets in a different way, or countered unwelcome effects by some other means. Although patients discussed stopping tablets with their doctor, they commonly did not discuss other reactions. Patients who accepted persistent unwelcome effects balanced them against reasons to take medication: positive experiences with doctors; perceived benefits of medication; or pragmatic considerations. These reasons overlap with those described previously as balancing patients' reservations about medicines.


CONCLUSIONS
The term 'side effect' fails to distinguish between palpable effects that are welcome or unwelcome, or to recognise that some unwelcome effects may nevertheless be acceptable. If clinicians explore the range of palpable effects that patients attribute to antihypertensives and patients' possible preparedness to tolerate unwelcome effects, they will be better able to identify patients' preferences in this area.
Benson
John
J
Applied Healthcare Research, Institute of Health and Social Care Research, Peninsula Medical School, St Lukes Campus, Exeter EX1 2LU, UK. Jab62@medschl.cam.ac.uk
Britten
Nicky
N
D000284:Administration, Oral; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005194:Family Practice / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017060:Patient Satisfaction; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014504:Urban Health
D000959:Antihypertensive Agents