How May Coexisting Frailty Influence Adherence to Treatment in Elderly Hypertensive Patients?


Journal

International journal of hypertension
ISSN: 2090-0384
Titre abrégé: Int J Hypertens
Pays: United States
ID NLM: 101538881

Informations de publication

Date de publication:
2019
Historique:
received: 06 09 2018
revised: 18 12 2018
accepted: 26 12 2018
entrez: 7 2 2019
pubmed: 7 2 2019
medline: 7 2 2019
Statut: epublish

Résumé

Hypertension is considered to be the most common condition in the general population. It is the most important risk factor for premature deaths in the world. Treatment compliance at every stage is a condition for successful antihypertensive therapy, and improving the effectiveness of treatment is a major goal in preventing cardiovascular incidents. Treatment noncompliance and lack of cooperation stem from numerous problems of older age, including frailty syndrome. To evaluate the effect of frailty syndrome on treatment compliance in older patients with hypertension. The study sample consisted of 160 patients (91 women, 69 men) with hypertension aged 65 to 78 (mean = 72.09, SD = 7.98 years), hospitalized at the University Clinical Hospital due to exacerbation of disease symptoms. Standardised research tools were used: the Tilburg Frailty Indicator questionnaire and the questionnaire for the assessment of treatment compliance in patients with hypertension, the Hill-Bone Compliance to High Blood Pressure Therapy Scale. Frailty syndrome was diagnosed in 65.62% of patients: 35.62% with mild, 29.38% with moderate, and 0.62% with severe frailty. The treatment compliance was 36.14%. The prevalence of the FS and its three components (physical, psychological, social) significantly affected (p <0.05) the global score of the Hill-Bone Compliance to High Blood Pressure Therapy Scale and all subscales: "reduced sodium intake", "appointment keeping", and "antihypertensive medication taking". The coexistence of frailty syndrome has a negative impact on the compliance of older patients with hypertension. Diagnosis of frailty and of the associated difficulties in adhering to treatment may allow for targeting the older patients with a poorer prognosis and at risk of complications from untreated or undertreated hypertension and for planning interventions to improve hypertension control.

Sections du résumé

BACKGROUND BACKGROUND
Hypertension is considered to be the most common condition in the general population. It is the most important risk factor for premature deaths in the world. Treatment compliance at every stage is a condition for successful antihypertensive therapy, and improving the effectiveness of treatment is a major goal in preventing cardiovascular incidents. Treatment noncompliance and lack of cooperation stem from numerous problems of older age, including frailty syndrome.
OBJECTIVE OBJECTIVE
To evaluate the effect of frailty syndrome on treatment compliance in older patients with hypertension.
METHODS METHODS
The study sample consisted of 160 patients (91 women, 69 men) with hypertension aged 65 to 78 (mean = 72.09, SD = 7.98 years), hospitalized at the University Clinical Hospital due to exacerbation of disease symptoms. Standardised research tools were used: the Tilburg Frailty Indicator questionnaire and the questionnaire for the assessment of treatment compliance in patients with hypertension, the Hill-Bone Compliance to High Blood Pressure Therapy Scale.
RESULTS RESULTS
Frailty syndrome was diagnosed in 65.62% of patients: 35.62% with mild, 29.38% with moderate, and 0.62% with severe frailty. The treatment compliance was 36.14%. The prevalence of the FS and its three components (physical, psychological, social) significantly affected (p <0.05) the global score of the Hill-Bone Compliance to High Blood Pressure Therapy Scale and all subscales: "reduced sodium intake", "appointment keeping", and "antihypertensive medication taking".
CONCLUSIONS CONCLUSIONS
The coexistence of frailty syndrome has a negative impact on the compliance of older patients with hypertension. Diagnosis of frailty and of the associated difficulties in adhering to treatment may allow for targeting the older patients with a poorer prognosis and at risk of complications from untreated or undertreated hypertension and for planning interventions to improve hypertension control.

Identifiants

pubmed: 30723553
doi: 10.1155/2019/5245184
pmc: PMC6339701
doi:

Types de publication

Journal Article

Langues

eng

Pagination

5245184

Références

J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56
pubmed: 11253156
J Hypertens. 2001 Dec;19(12):2281-3
pubmed: 11725175
JAMA. 2003 May 21;289(19):2560-72
pubmed: 12748199
J Hypertens Suppl. 1992 Aug;10(6):S73-7
pubmed: 1432333
Hypertension. 2004 Jan;43(1):10-7
pubmed: 14638619
J Hum Hypertens. 2004 Mar;18(3):139-85
pubmed: 14973512
CMAJ. 2005 Aug 30;173(5):489-95
pubmed: 16129869
Am J Med. 2005 Nov;118(11):1225-31
pubmed: 16271906
Hypertension. 2007 Jan;49(1):69-75
pubmed: 17159087
Kardiol Pol. 2005;63(6 Suppl 4):S614-9
pubmed: 20527432
Circulation. 2011 Feb 1;123(4):e18-e209
pubmed: 21160056
Gerontologist. 2012 Oct;52(5):619-31
pubmed: 22217462
Ageing Res Rev. 2013 Mar;12(2):719-36
pubmed: 22426304
Lancet. 2013 Mar 2;381(9868):752-62
pubmed: 23395245
Hypertens Res. 2013 Jul;36(7):639-44
pubmed: 23446774
J Hypertens. 2013 Jul;31(7):1281-357
pubmed: 23817082
Qual Life Res. 2014 Oct;23(8):2289-300
pubmed: 24671672
J Clin Oncol. 2014 Aug 1;32(22):2318-27
pubmed: 24934786
Patient Prefer Adherence. 2014 Oct 31;8:1521-6
pubmed: 25382973
BMC Med. 2015 Apr 09;13:78
pubmed: 25880068
Hypertension. 2015 Oct;66(4):742-9
pubmed: 26222709
Kardiol Pol. 2016;74(3):213-23
pubmed: 27004543
J Am Soc Hypertens. 2016 Jun;10(6):536-41
pubmed: 27118485
BMC Cardiovasc Disord. 2016 May 10;16:87
pubmed: 27165782
PeerJ. 2016 Jun 14;4:e2122
pubmed: 27326380
High Blood Press Cardiovasc Prev. 2017 Mar;24(1):1-11
pubmed: 28181201
Ther Adv Drug Saf. 2017 Apr;8(4):117-132
pubmed: 28439398
Clin Interv Aging. 2017 May 15;12:805-814
pubmed: 28553089
Hypertension. 2017 Aug;70(2):253-254
pubmed: 28652460
Sci Rep. 2017 Aug 8;7(1):7542
pubmed: 28790349
J Clin Hypertens (Greenwich). 2018 Jan;20(1):186-192
pubmed: 29105991
Card Fail Rev. 2017 Nov;3(2):102-107
pubmed: 29387461
Am J Public Health. 1996 Dec;86(12):1805-8
pubmed: 9003143

Auteurs

Bartosz Uchmanowicz (B)

Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, 5 Bartla Street, 51-618 Wroclaw, Poland.

Anna Chudiak (A)

Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, 5 Bartla Street, 51-618 Wroclaw, Poland.

Izabella Uchmanowicz (I)

Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, 5 Bartla Street, 51-618 Wroclaw, Poland.

Grzegorz Mazur (G)

Department and Clinic of Internal and Occupational Diseases and Hypertension, Jan Mikulicz-Radecki University Teaching Hospital in Wroclaw, 213 Borowska Street, 50-556 Wrocław, Poland.

Classifications MeSH