title: Selected factors affecting adherence in the pharmacological treatment of arterial hypertension.
abstract: BACKGROUND
  Low adherence to hypertension (HT) management is one of the major contributors to poor blood pressure (BP) control. Approximately 40%-60% of patients with HT do not follow the prescribed treatment. The aim of the study was to analyze the relationship between selected variables and adherence to hypotensive pharmacological treatment. Besides socioclinical variables, the study focused on the role of illness acceptance.
  
  
  METHODS
  The study included 602 patients with HT. Adherence and acceptance of illness were assessed using the following validated instruments: the Acceptance of Illness Scale (AIS) and the Morisky Medication Adherence Scale (MMAS).
  
  
  RESULTS
  The high-adherence group comprised a significantly higher percentage of patients with high illness acceptance scale scores than that of patients with low-to-moderate scores (42.4 vs 31.8%;P=0.008<0.01). The odds ratio (OR) showed that high adherence to pharmacological treatment was >1.5 times as likely to occur in the high acceptance group as in the low-to-moderate acceptance group (OR =1.58, 95% CI 1.14-2.19). Spearman's rank correlation coefficients showed statistically significant correlations between adherence and sex (menρ=-0.101;P=0.012), age >45-66 years (ρ=0.098;P=0.015), higher education level (ρ=0.132;P=0.001), grade ESC of HT (ρ=-0.037;P=0.057), receiving one-tablet polytherapy (ρ=0.131;P=0.015), and illness acceptance (ρ=0.090;P=0.024).
  
  
  CONCLUSIONS
  Acceptance of illness is correlated with adherence to pharmacological treatment, and consideration should be given to more widespread assessment of illness acceptance in daily practice. Male sex, age >45-66 years, duration of illness grade ESC of HT, and receiving one-tablet polytherapy are significant determinants of adherence to pharmacological treatment in HT.
authors.affiliation: Department of Clinical Nursing, Wroclaw Medical University.
authors.forename: Beata
authors.initials: B
authors.lastname: Jankowska-Polańska
authors.affiliation: Department of Clinical Nursing, Wroclaw Medical University.
authors.forename: Anna
authors.initials: A
authors.lastname: Chudiak
authors.affiliation: Department of Clinical Nursing, Wroclaw Medical University.
authors.forename: Izabella
authors.initials: I
authors.lastname: Uchmanowicz
authors.affiliation: Department of Logistics and Transport Systems, Faculty of Mechanical Engineering, Wrocław University of Technology.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Dudek
authors.affiliation: Department and Clinic of Internal and Occupational Diseases and Hypertension, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Mazur
keywords: adherence; hypertensive treatment; illness acceptance