Adherence to pharmacological and non-pharmacological treatment of frail hypertensive patients

Objective: To investigate the relationship between frailty syndrome (FS) and adherence to pharmacological and non-pharmacological treatment for hypertension.

Methods: The study included 100 patients diagnosed with hypertension and treated with one or more hypotensive drugs.

Results: Frail patients obtained low scores (4.1 ± 2.0) for adherence to pharmaceutical treatment of hypertension, while non-frail patients obtained moderate scores (6.1 ± 2.1). Non-frail patients had higher scores in two out of four domains of the Health Behavior Inventory (HBI): positive mental attitudes (3.6 ± 0.4 vs. 3.2 ± 0.5; P = 0.006) and health practices (3.6 ± 0.5 vs. 3.2 ± 0.5; P < 0.03); as well as higher global scores (HBI raw score): 83.3 ± 10.6 vs. 77.3 ± 9.5; P < 0.03. Multiple regression analysis showed that frailty syndrome (FS) was a statistically significant independent determinant of worse adherence to pharmacological treatment (β = -0.27; P < 0.001) and health behaviors (β = -0.10; P = 0.036). Education was a statistically significant independent determinant of better adherence to pharmacological treatment (β = 0.82; P = 0.012), while net income positively affected health behaviors as measured by the HBI (β = 0.39; P = 0.046).

Conclusions: FS is a significant independent factor contributing to worse adherence to pharmacological and non-pharmacological treatment of hypertension. Better education significantly improves patients' adherence to the prescribed pharmacological treatment, while a good financial standing evidenced by high net income is a determinant of better adherence to health-related behaviors recommended in hypertension treatment.