RELATIONSHIP BETWEEN DOSAGE REGIMENS OF ACE-INHIBITORS AND PATIENTS’ ADHERENCE IN GENERAL PRACTICE: A PILOT STUDY
Abstract
Background / Aim. High adherence to angiotensin-converting-enzyme inhibitors in newly diagnosed hypertensive patients reduces the risk of cardiovascular complications. The aim of this pilot study was to assess the adherence level in patients by Morisky-8 item scale and to determine whether it is different if the medicine is taken in single or multiple daily doses.
Methods. In this study 51 hypertensive patient (60.8% women) on monotherapy with angiotensin-converting-enzyme (ACE) inhibitor was included, categorized into two groups (A and B) based on the number of daily doses that were used in therapy. On the basis of the results of Morisky-8 scale, the patients were categorized in 3 subgroups. The patients that had a score on the Morisky-8 item scale > 2 were categorized as low adherent, those with a score of 1 or 2 were medium adherent and those with Morisky score zero were categorized as highly adherent.
Results. According to the Morisky-8 scale, from the total number of respondents 51% were categorized as low adherent, 31.4% as medium adherent and 17.6% were categorized as highly adherent; the average value of the Morisky-8 score was 2.8 ± 2.3 points. Group A (patients who were taking medication divided into multiple daily doses) consisted of 83.3% low adherent, 12.5% medium adherent and 4.2% highly adherent patients, and the average score was 4.42 ± 1.9 points. In the group B (patients who were taking their medication in a single daily dose) 22.2% were low adherent, 48.1% medium adherent and 29.7% highly adherent patients; the average score was 1.37 ± 1.4 points. The average Morisky-8 scale scores of the examined groups were significantly different (p-value<0.0001).
Conclusion. The results show that more than half of the patients have low levels of adherence. Comparing groups A and B, we found that adherence was lower in group A, which may indicate that the level of adherence is higher if the drug is used in a single daily dose.
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