OP.2B.09] PERSISTENCE TO ANTIHYPERTENSIVE TREATMENT – A CROSS-SECTIONAL STUDY OF PATIENTS’ ATTITUDES TOWARDS HYPERTENSION AND MEDICATION

Abstract

Objective: To assess potential differences in patient attitudes towards hypertension and antihypertensive medication between patients persistent and non-persistent to antihypertensive drug therapy. Design: Cross-sectional study based on patient questionnaires linked with national register data on dispensed drugs. Design and method: This study included 711 hypertensive patients (mean age 62 years; 50% women) who during 2016 attended any of 25 primary healthcare centres in Stockholm, Sweden. Patients’ attitudes towards hypertension and drugs were assessed by the “Brief Illness Perception” and the “Beliefs about Medicines” questionnaires and sent 3–12 months after initiation of drug treatment; response rate was 59%. Patients were classified as persistent (609, 86%) or non-persistent (102, 14%) to antihypertensive treatment by analyses of their filled prescriptions from the Swedish Prescribed Drug Register, which includes information on all dispensed drugs from community pharmacies in Sweden. Results: Mean systolic and diastolic blood pressure before initiation of treatment was 160 ± 18/93 ± 12 mm Hg. Cardiovascular comorbidity (atrial fibrillation, heart failure, ischemic heart disease or previous stroke/transient ischemic attack) was present in 5%, and diabetes mellitus in 7% of the patients. Almost one third were born outside Sweden. Compared to non-persistent medication users, persistent patients considered their diagnosis of hypertension to be chronic to a higher degree (median [interquartiles]; all P < 0.04) (6 [4–10] vs. 4 [2–8]), had less consequences on their life (2 [0–5] vs. 3 [1–6]), and that cardiovascular disease could be prevented by antihypertensive treatment (median 7 [5–8] vs. 5 [3–8]). Persistent patients had a greater belief in potential benefits from treatment (median 16 [15–18] vs. 16 [15–17.5]), thought less in doctors putting too much trust in drugs (median 12 [10–14] vs. 13 [11–14]), considered to a higher extent that antihypertensive drugs were necessary in order to maintain or improve their own health (median 17 [14–19] vs. 16 [11–19]) and were less concerned about the negative effects of their antihypertensive treatment (median 12 [8–15] vs. 12 [9–17]). Conclusions: Primary healthcare providers should further emphasize the chronicity of hypertension as a disease, and the benefits of treatment in order to improve patients’ persistence to antihypertensive treatment.