Patient Preference and Adherence (Dec 2018)
The influence of quality of life on the level of adherence to therapeutic recommendations among elderly hypertensive patients
Abstract
Bartosz Uchmanowicz,1 Anna Chudiak,1 Grzegorz Mazur2 1Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland; 2Department and Clinic of Internal and Occupational Diseases and Hypertension, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland Background: Hypertension is one of the most important risk factors for cardiovascular disease, which contributes to lowering the quality of life (QOL), especially in elderly patients. Recent data show that almost half of the hypertensive patients and one-third of patients with comorbidities were nonadherent to medication. Objective: To assess the association of QOL with the level of adherence and to examine the association with selected variables on the level of adherence. Design: A prospective, cross-sectional, and analytical study. Methods: This study involved 186 hypertensive elderly patients (mean age: 71.05±7.47 years). An analysis of medical records based on sociodemographic and clinical data was conducted. The World Health Organization Quality of Life Scale Brief version (WHOQOL-BREF) was used to assess the level of QOL, and the Hill-Bone Compliance to High Blood Pressure Therapy Scale (HBQ) was used to examine the level of adherence to therapeutic recommendations in hypertensive patients. Results: The average assessment of the QOL measured by the WHOQOL-BREF questionnaire was 3.36±0.84 points, which indicates a QOL at a level between average and good. The patients’ average score on the HBQ questionnaire was 20.39±4.31 points. In the “reduced sodium intake” subscale, patients had an average of 4.75±1.33 points. In the “appointment keeping” subscale, the patients scored an average of 3.45±1.07 points. In the “medication taking” subscale, the patients had an average of 12.19±3.46 points. It was shown that the total score of the HBQ questionnaire was negatively correlated with all domains of QOL assessed with the WHOQOL-BREF questionnaire (P<0.05). Conclusion: There is an association between QOL and adherence to therapeutic recommendations among hypertensive elderly patients. It has been concluded that with an increasing QOL, the level of adherence to therapeutic recommendations increases. The level of adherence is also negatively affected by: older age, longer duration of disease, worse marital status, lower education, living alone, and using polytherapy. Keywords: hypertension, adherence, elderly patients, WHOQOL-BREF questionnaire, Hill-Bone Compliance questionnaire, cross-sectional study
