Adherencija prema terapiji kod pacijenata sa esencijalnom hipertenzijom - PhDData

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Adherencija prema terapiji kod pacijenata sa esencijalnom hipertenzijom

The thesis was published by Halgato Tinde, in November 2023, University of Novi Sad.

Abstract:

Introduction: Adherence to antihypertensive therapy is the main problem in the management of essential hypertension. In Serbia, despite the high prevalence of essential hypertension, the research conducted in this area is not sufficient to identify the adherence status. The objectives of the research are: To determine and compare: 1) adherence by pill count and questionnaire; 2) knowledge about essential hypertension and quality of life; 3) examine the connection of knowledge about essential hypertension to blood pressure values, adherence and quality of life; 4) determine and compare predictors of non-adherence in patients with essential hypertension in two study place with different levels of health care. Material and methods: The research included respondents with a diagnosis of essential arterial hypertension, aged over 20 years, from two study place: from the municipality of Bačka Topola, where health services are provided at the primary level, and in the municipality of Sombor, where, in addition to the primary level, health care for patients with essential hypertension, health care is also provided at the secondary level. During the research, the adherence to mantihypertensive therapy was determined using two methods, the knowledge about essential hypertension and the quality of life of the respondents were examined using a questionnaire. The research was conducted in the period from July 1st, 2019. until April 30th, 2020. Results: Adherence determined by the pill count was 39.6%, and measured by the questionnaire was 27.4%. There was no statistically significant difference in the frequency of respondents’ adherence between the two study place with different levels of health care. 57.1% of all respondents had averageĀ  knowledge about essential hypertension. The quality of life of all respondents was below average (PCS= 40.5; MCS=44.3). Respondents from the study place with a secondary level of health care had a statistically lower level of knowledge about essential hypertension and lower scores of the quality of life dimension compared to respondents the from study place with a primary level of health care. Knowledge about essential hypertension had a significant impact on blood pressure values, adherence and quality of life. The predictors of non-adherence determined by the method of pill counts were: co-payment of drug prices, higher number of drugs per day, uncontrolled blood pressure, lower level of knowledge about essential hypertension. Statistically significant predictors of non-adherence measured using the questionnaire were: co- payment of drug prices, uncontrolled blood pressure, lower level of knowledge about essential hypertension and lower score of the mental health dimension. Conclusion: Adherence is suboptimal in both study place with different level of health care and treatment of essential hypertension insufficient. It is necessary to provide more medical personnel and enable continuous monitoring of patients, to reduce the additional payment for fixed dose combinations for hypertension. It is necessary to improve knowledge about essential hypertension, among patients, which will contribute to better adherence to therapy and quality of life



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