SAAME study: Scottish adherence to antihypertensives medication in the elderly

Detection and treatment of hypertension continues to be a major public health challenge affecting between 30-45% of the general population, increasing steeply with age. Many studies have shown the benefit of antihypertensive agents in improving clinical outcomes. However, their effectiveness is dependent on persistent adherence to prescribed medication.

Funding Body

NHS Education for Scotland

Abstract

Method

Pre-registration pharmacy trainees (pre-regs) undertaking postgraduate placement-in-practice based in community pharmacies across Scotland were invited to take part. Each pre-reg invited and consented up to 15 patients (aged 65 plus; at least one prescribed medication) presenting with a prescription which indicated treatment for hypertension, to take part in a telephone interview. The structured interview focused on patient’s beliefs about medicines and medication adherence.

Results

Of the 130 pre-regs working in community pharmacy in Scotland 92% (n=119) took part with a patient-participant response rate of 75% (n=1332). 94% of respondents always-or-often strive to follow doctor’s instructions and have a strict routine for use of their regular medicines. 87% rarely-or-never get confused about their medicines. 78% of respondents believed their medication prevented them becoming ill; unpleasant side effects were reported by 8%. 93% said taking medication did not disrupt their life. Respondents had visited a medical practice twice in previous six months. 69% reported normal blood pressure. 49% of respondents had previously smoked daily; 13% currently smoke.

Conclusion

The SAAME study provides strong evidence of patients adhering to antihypertensive medication, also a model for promoting evidenced-based community pharmacy services: public health data year-on-year; raise the profile of clinical research in community pharmacy services. Feedback suggests pharmacies have concerns about telephone interviews preventing calls coming in so would prefer the option of face-to-face interviews; also direct online entry of data, and; online consent forms for the pre-regs. Future research is planned around evaluating pre-reg engagement, training needs, impact on community pharmacy based tutors and staff.