Publicação
Análise do comportamento do MUAH-16 numa população de doentes com insuficiência cardíaca
| Resumo: | Heart Failure (HF) is one of most deadly and disabling cardiovascular diseases and its incidence is increasing steadily with the ageing of the western population. Adherence to antihypertensive therapy has a major influence on the outcomes of heart failure, not limited only to the treatment of high blood pressure, but also the regulation of the hydro-electrolytic balance and the reduction of cardiac workload. In order to achieve better outcomes, the identification of the main reasons underlying the low adherence rates to optimized HF medical therapy will allow us to develop more individualized strategies.This study aimed to evaluate heart failure patients' adherence to antihypertensive therapy and associated causes for non-adherence. We also intended to compare the scores obtained within the two defined study arms – hypertensive (HT) and hypotensive (HoT)- within the HF group. METHODSCross-sectional study conducted in the cardiology department of Coimbra´s Tertiary Hospital. Between June 2019 and November 2019 all consecutive adult heart failure patients attending to the outpatient HF outpatient clinic, with a prescription of, at least, one antihypertensive drug, were invited to participate. This study was approved by the local Ethics Commission (CE 008-19).Socio-demographic and patient-related data were collected and the short version of Maastricht Utrecht Adherence in Hypertension (MUAH-16) was applied. Statistical analysis was performed using the IBM SPSS® Statistics software. Socio-demographic and patient-related data were collected and the short version of Maastricht Utrecht Adherence in Hypertension (MUAH-16) was applied. Statistical analysis was performed using the IBM SPSS® Statistics software. A total of 125 patients were enrolled in the study, 72.8% males, with a mean age of 65.7 ± 1.7 years (62 HT + 63 HoT). The patients who presented with normal blood pressure were assigned to the HT group.The mean score of MUAH-16 on the total sample was 93.4 ± 7. 5 (in a possible range of 16 to 112), with no statistically significant differences between HT and HoT patients. Considering the mean scores of MUAH-16 subscales, being 28 points the maximum scoring, the results obtained were: positive attitude toward health care and medication: 25.9 ± 2.6; lack of discipline: 25.4 ± 3.5; aversion toward medication: 19.7 ± 4.7, and active coping with health problems: 22.1 ± 3.3. Sub-group analysis shows no statistically significant differences between HT and HoT patients.The studied population showed satisfactory levels of adherence to antihypertensive therapy, even so, improvements can be obtained if specific strategies to decrease aversion toward medication and to improve active coping with health problems are developed. |
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| Autores principais: | Pedroso, Diogo Alexandre Carvalho |
| Assunto: | Insuficiência Cardíaca Adesão e compliance à terapêutica Medicação antihipertensora Questionários MUAH-16 Heart Failure Treatment Adherence and Compliance Antihypertensive Agents Questionnaires MUAH-16 |
| Ano: | 2020 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso embargado |
| Instituição associada: | Universidade de Coimbra |
| Idioma: | português |
| Origem: | Estudo Geral - Universidade de Coimbra |
| Resumo: | Heart Failure (HF) is one of most deadly and disabling cardiovascular diseases and its incidence is increasing steadily with the ageing of the western population. Adherence to antihypertensive therapy has a major influence on the outcomes of heart failure, not limited only to the treatment of high blood pressure, but also the regulation of the hydro-electrolytic balance and the reduction of cardiac workload. In order to achieve better outcomes, the identification of the main reasons underlying the low adherence rates to optimized HF medical therapy will allow us to develop more individualized strategies.This study aimed to evaluate heart failure patients' adherence to antihypertensive therapy and associated causes for non-adherence. We also intended to compare the scores obtained within the two defined study arms – hypertensive (HT) and hypotensive (HoT)- within the HF group. METHODSCross-sectional study conducted in the cardiology department of Coimbra´s Tertiary Hospital. Between June 2019 and November 2019 all consecutive adult heart failure patients attending to the outpatient HF outpatient clinic, with a prescription of, at least, one antihypertensive drug, were invited to participate. This study was approved by the local Ethics Commission (CE 008-19).Socio-demographic and patient-related data were collected and the short version of Maastricht Utrecht Adherence in Hypertension (MUAH-16) was applied. Statistical analysis was performed using the IBM SPSS® Statistics software. Socio-demographic and patient-related data were collected and the short version of Maastricht Utrecht Adherence in Hypertension (MUAH-16) was applied. Statistical analysis was performed using the IBM SPSS® Statistics software. A total of 125 patients were enrolled in the study, 72.8% males, with a mean age of 65.7 ± 1.7 years (62 HT + 63 HoT). The patients who presented with normal blood pressure were assigned to the HT group.The mean score of MUAH-16 on the total sample was 93.4 ± 7. 5 (in a possible range of 16 to 112), with no statistically significant differences between HT and HoT patients. Considering the mean scores of MUAH-16 subscales, being 28 points the maximum scoring, the results obtained were: positive attitude toward health care and medication: 25.9 ± 2.6; lack of discipline: 25.4 ± 3.5; aversion toward medication: 19.7 ± 4.7, and active coping with health problems: 22.1 ± 3.3. Sub-group analysis shows no statistically significant differences between HT and HoT patients.The studied population showed satisfactory levels of adherence to antihypertensive therapy, even so, improvements can be obtained if specific strategies to decrease aversion toward medication and to improve active coping with health problems are developed. |
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