The effect of the content of the knowledge on adherence to medication in hypertensive patients.
OBJECTIVE
It was suggested that knowledge might influence the adherence to treatment in hypertension. Accordingly, in this study, we investigated the effects of content of knowledge on medication adherence and knowledge-based predictors of adherence to treatment in hypertensive patients.


METHODS
This cross-sectional study included 227 hypertensive patients (70% female;mean age: 57+/-12 years), who were followed by cardiology and internal medicine clinics. The patients were asked to fulfill a questionnaire including 40 items. Besides the demographic and disease-related questions, the patients were also asked (1) the name of the drug, (2) the duration of the drug use;(3) the reason of using the drug;(4) the cause of hypertension;(5) the target level of hypertension;(6) the result of hypertension;(7) the side effects of antihypertensive medicines. Statistical analyses were performed using Chi-square, Fischer exact, Mann Whitney U tests and logistic regression analysis.


RESULTS
It was found that 163 (72%) were adherent and 64 (28%) were nonadherent to the treatment. Angiotensin-II receptor antagonist use (OR=4.405;95%CI: 1.561-12.365, p=0.022) and hypertension duration > or =5 years (OR=0.446;95%CI: 0.246-0.811, p=0.006) was found to be independently related to adherence. Among the knowledge-based variables, knowing the duration of use of the medicine (OR=6.822;95% CI: 1.478-31.241, p=0.075), the reason of use of medicine (OR=2.828;95% CI: 1.445-5.543, p=0.018), the cause of the hypertension (OR=3.447;95% CI: 1.889-6.290, p=0.037) and the target level of blood pressure (OR=12.859;95% CI: 5.045-32.640, p<0.001) significantly increased the adherence rates. On the other hand, knowing the name of the medicine (p=0.112) or the results of hypertension (p=0.719) had no effect on adherence, while knowing the side effects of the medicine (OR=0.607;95% CI: 0.340-1.084, p=0.005) had negative effect. The total number of correct answers was also higher in patients with adherence to treatment (p=0.002).


CONCLUSIONS
Patient knowledge about hypertension and medications is associated with higher adherence rates. However, it should be taken into consideration that the possible effects of knowledge may differ according to its content.
Karaeren
Hayrettin
H
Department of Cardiology, Gülhane Military Medical Academy, Ankara, Turkey.
Yokuşoğlu
Mehmet
M
Uzun
Senay
S
Baysan
Oben
O
Köz
Cem
C
Kara
Belgüzar
B
Kirilmaz
Ata
A
Naharci
Ilkin
I
Pinar
Murat
M
Yilmaz
Mehmet Birhan
MB
Uzun
Mehmet
M
D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010361:Patients / Q000523:psychology*; D011795:Surveys and Questionnaires
D000959:Antihypertensive Agents