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Patient Perceptions Vital In Continuing Antihypertensives
British Medical Journal (BMJ)
10/23/2002
By Harvey McConnell
The way the risks and benefits of antihypertensives are presented to patients by doctors can affect how the patients take the medications.
Researchers into primary care at the Institute of Health, Cambridge University, Cambridge, and at Guy's, King's and St Thomas's Hospital, London, England, point out that - taking into account definitions and measurements made in many studies - it is estimated 50 percent of people diagnosed with hypertension do not take the drugs they are prescribed. Many patients taking drugs for chronic diseases make active decisions about their drugs, rather than being passive recipients of medical care, and they may draw on both medical and non-medical sources.
Using two urban family practices, the researchers studied 38 patients who were receiving repeat prescriptions for antihypertensive medications. The patients were questioned about any reservations they had about taking antihypertensives.
There were a marked variety of responses from patients. Many said that the drugs are best avoided because they are unnatural or unsafe, their use signifies ill health, doctors prescribe them too readily, and because of previous experience from taking drugs. As for their antihypertensive therapy, the patients said they would like to discontinue their use, would like an alternative to drugs, and they questioned the continued necessity of continuing to take antihypertensives because of possible long-term or hidden risks.
The researchers said that "patients may make different choices about taking antihypertensives, depending on which way the risk is presented, and our study confirms the importance for patients of what doctors say when balancing reservations with reasons for taking drugs." However, they also found that different patients may balance similar perceptions differently, and a single patient may balance multiple reservations against reasons for taking drugs that are different for each reservation.
"If information is to be offered to patients in a way that connects with their personal understanding, it is necessary to appreciate not only a patient's perceptions but also the way that they balance for that individual," the researchers conclude.
BMJ 2002;325:873.
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