Medication adherence: It's not what you say but how you say it

Abstract

Method: We carried out a cross-sectional survey conducted in six Family Health Units of the Brazilian Unified Health System, in Maceio, between November 2012 and March 2013. Data were collected through home interviews. Adherence was assessed using a validated version in Portuguese of the 8-item Morisky Medication Adherence Scale (MMAS-8). In this study, the patients were considered adherent if they had a score greater than or equal to 6 in the MMAS-8. Although the Brazilian public health system must provide free access to antihypertensive drugs to all hypertensive patients in the country, many patients prefer to pay for their medicines because of accessibility and convenience of private community pharmacies, thus in our study patients who had purchased at least one antihypertensive drug in the thirty days preceding the interview were excluded. Results: 685 of 720 eligible patients were assessed for adherence. 346 patients (50.5%) were considered adherent to antihypertensive therapy, which is a prevalence similar to other studies. The mean age of patients was 58.4 years (SD 1⁄4 10.9 years), with 49.5% older than 60 years, 68.0% female. Mean number of prescribed antihypertensives per patient was 1.64 (SD 1⁄4 0.9). These potential confounding factors (age, sex, number of prescribed medications) did not influence medication adherence (PO.05; Pearson chi-square). Conclusion: Although cost of medication is the modifiable barrier to adherence most well described in the literature, the removal of this factor did not improve* medication adherence among low-income hypertensive patients.