Low medication adherence tied to decline in health-related QOL in elderly Hypertensives
Health-related quality of life (HRQOL) is an indicator of how a health condition and its treatment affect the physical, emotional and social well being. A recent study published in the Journal of Hypertension suggests Low self-report medication adherence is associated with the decline in mental health-related quality of life (HRQOL) over 1 year in older adults with hypertension.
Antihypertensive medications can lower blood pressure (BP) and reduce CVD risk; yet, only about half of adults with hypertension take their medications as prescribed. Although several previous cross-sectional studies have shown an association between low antihypertensive medication adherence and poor HRQOL, only a few data exist on the effect of low adherence on change in HRQOL over time in older adults. For this purpose, researchers evaluated the association of low antihypertensive medication adherence with the decline in health-related quality of life (HRQOL) over 1 year.
They conducted a longitudinal secondary analysis of data from the Cohort Study of Medication Adherence among Older Adults (CoSMO), which was a prospective cohort study of factors associated with antihypertensive medication adherence and CVD among older adults with hypertension. They used data of 1525 elders from CoSMO trial and analyzed the adherence using validated self-report four-item Krousel-Wood Medication Adherence Scale (K-Wood-MAS-4) (low adherence = score ≥1) and prescription refill-based proportion of days covered (PDC) (low adherence = PDC < 0.80). A decline in HRQOL is referred to decrease in Mental Component Summary (MCS) or Physical Component Summary (PCS) score. They also calculated the minimal important difference (MID) as the average of MID estimates for each summary score derived from distribution and anchor-based approaches.
Key findings of the study were:
♦Researchers have found the prevalence of low adherence was 38.6% using the K-Wood-MAS-4 and 23.9% using PDC.
♦Based on mean MID, they noted estimates of 4.40 for MCS and 5.16 for PCS.
♦They observed 21.8% of participants experienced MCS and 25.2% of participants experienced PCS over 1 year.
♦They reported Low adherence was associated with a decline in MCS for K-Wood-MAS-4 [prevalence ratio = 1.32], but not PDC (prevalence ratio = 1.17). However it was not associated with decline in PCS (K-Wood-MAS-4: prevalence ratio = 0.95; PDC: prevalence ratio = 1.10)
The authors concluded, "Low self-report medication adherence is associated with the decline in mental HRQOL over 1 year in older adults with hypertension".
They further added, "Further work is needed to confirm findings in larger and more diverse populations and to investigate whether improvements in antihypertensive medication adherence are associated with improvements in HRQOL for older adults with hypertension".
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