The influence of cognition, anxiety and psychiatric disorders over treatment adherence in uncontrolled hypertensive patients.

<h4>Background</h4>Poor adherence is estimated to cause 125 thousand deaths per year and is linked to 10% of all hospital stays in the U.S. Up to one third of elderly hypertensive patients don't have adherence, which is responsible for high proportion of hospitalizations. Hypertensi...

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Autores principales:	Úrsula Jacobs, Mauro S De Castro, Flávio D Fuchs, Maria Beatriz C Ferreira
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a1eb2446d2ae4cc2b90b27057eeee840
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spelling	oai:doaj.org-article:a1eb2446d2ae4cc2b90b27057eeee8402021-11-18T06:48:26ZThe influence of cognition, anxiety and psychiatric disorders over treatment adherence in uncontrolled hypertensive patients.1932-620310.1371/journal.pone.0022925https://doaj.org/article/a1eb2446d2ae4cc2b90b27057eeee8402011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21857969/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Poor adherence is estimated to cause 125 thousand deaths per year and is linked to 10% of all hospital stays in the U.S. Up to one third of elderly hypertensive patients don't have adherence, which is responsible for high proportion of hospitalizations. Hypertension is also related to poor performance in tests that assess cognitive functions. On the other hand, poor cognitive performance is associated with low adherence to treatment.<h4>Objective</h4>To assess the association between cognitive function, anxiety and psychiatric disorders with adherence to drug treatment in patients with hypertension.<h4>Methodology and principal findings</h4>This a cohort studies with 56 adult patients with uncontrolled hypertension who participated of all meetings of a pharmaceutical intervention in a randomized clinical trial of pharmaceutical care. Cognitive function was measured by the Mini Mental State Examination (Mini-mental). The memory was measured by digit and word spans, tower and church shadow test, short story test and metamemory. Anxiety and psychiatric disorders were evaluated by the State Trace Anxiety Inventory and the Self-Report Questionnaire, respectively. The participants were classified as adherent or non-adherent to the drug treatment, according to the identification of plasma levels of hydrochlorothiazide. All non-adherent patients (n = 12) and 35 out 44 (79.5%) patients with adherence to treatment had at least one memory test with an altered score (P = 0.180). Participants with an unsatisfactory score in the Mini-mental had six-fold higher risk of non-adherence to treatment when compared to those with a normal score (RR = 5.8; CI 95%: 1.6-20.8; P = 0.007). The scores of anxiety and psychiatric disorders were not associated with adherence to the pharmacological treatment.<h4>Conclusion</h4>Cognitive deficit impairs adherence to drug therapy and should be screened as part of a program of pharmaceutical care to improve adherence to treatment.Úrsula JacobsMauro S De CastroFlávio D FuchsMaria Beatriz C FerreiraPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 8, p e22925 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Úrsula Jacobs Mauro S De Castro Flávio D Fuchs Maria Beatriz C Ferreira The influence of cognition, anxiety and psychiatric disorders over treatment adherence in uncontrolled hypertensive patients.
description	<h4>Background</h4>Poor adherence is estimated to cause 125 thousand deaths per year and is linked to 10% of all hospital stays in the U.S. Up to one third of elderly hypertensive patients don't have adherence, which is responsible for high proportion of hospitalizations. Hypertension is also related to poor performance in tests that assess cognitive functions. On the other hand, poor cognitive performance is associated with low adherence to treatment.<h4>Objective</h4>To assess the association between cognitive function, anxiety and psychiatric disorders with adherence to drug treatment in patients with hypertension.<h4>Methodology and principal findings</h4>This a cohort studies with 56 adult patients with uncontrolled hypertension who participated of all meetings of a pharmaceutical intervention in a randomized clinical trial of pharmaceutical care. Cognitive function was measured by the Mini Mental State Examination (Mini-mental). The memory was measured by digit and word spans, tower and church shadow test, short story test and metamemory. Anxiety and psychiatric disorders were evaluated by the State Trace Anxiety Inventory and the Self-Report Questionnaire, respectively. The participants were classified as adherent or non-adherent to the drug treatment, according to the identification of plasma levels of hydrochlorothiazide. All non-adherent patients (n = 12) and 35 out 44 (79.5%) patients with adherence to treatment had at least one memory test with an altered score (P = 0.180). Participants with an unsatisfactory score in the Mini-mental had six-fold higher risk of non-adherence to treatment when compared to those with a normal score (RR = 5.8; CI 95%: 1.6-20.8; P = 0.007). The scores of anxiety and psychiatric disorders were not associated with adherence to the pharmacological treatment.<h4>Conclusion</h4>Cognitive deficit impairs adherence to drug therapy and should be screened as part of a program of pharmaceutical care to improve adherence to treatment.
format	article
author	Úrsula Jacobs Mauro S De Castro Flávio D Fuchs Maria Beatriz C Ferreira
author_facet	Úrsula Jacobs Mauro S De Castro Flávio D Fuchs Maria Beatriz C Ferreira
author_sort	Úrsula Jacobs
title	The influence of cognition, anxiety and psychiatric disorders over treatment adherence in uncontrolled hypertensive patients.
title_short	The influence of cognition, anxiety and psychiatric disorders over treatment adherence in uncontrolled hypertensive patients.
title_full	The influence of cognition, anxiety and psychiatric disorders over treatment adherence in uncontrolled hypertensive patients.
title_fullStr	The influence of cognition, anxiety and psychiatric disorders over treatment adherence in uncontrolled hypertensive patients.
title_full_unstemmed	The influence of cognition, anxiety and psychiatric disorders over treatment adherence in uncontrolled hypertensive patients.
title_sort	influence of cognition, anxiety and psychiatric disorders over treatment adherence in uncontrolled hypertensive patients.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/a1eb2446d2ae4cc2b90b27057eeee840
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The influence of cognition, anxiety and psychiatric disorders over treatment adherence in uncontrolled hypertensive patients.

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