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- Linkage between electronic prescribing data and pharmacy claims records to determine primary adherence: the case of antihypertensive therapy in the Lisbon and Tagus Valley Region, PortugalPublication . Coelho, AndréBackground: Hypertension (HT) is highly prevalent and a major risk factor for cardiovascular disease. Over 42% of Portuguese adults have HT. Even though the benefits of antihypertensive (AHT) drugs have been demonstrated, HT control remains inadequate. One major reason is that patients often fail to take their medications as prescribed. This paper aims to determine primary adherence to AHT therapy in newly diagnosed and treated hypertensive patients in Primary Health Care (PHC) units of Lisbon and Tagus Valley Health Region. Methods: This study reports data from a population-based, retrospective, cohort study from patients diagnosed with HT in PHC units of Lisbon and Tagus Valley Region from 1 January to 31 March 2011, with no prior use of AHT drugs. The primary adherence rate was expressed as the number of claims records/total number of prescriptions records. Data were collected from SIARS for each patient during a 2-year period. Results: Overall primary adherence rate was 58.5%, increasing with age. Rates were higher for men, living in the Lisbon Metropolitan Area and diagnosed with uncomplicated HT. Drugs acting on the renin-angiotensin system had the highest rates, increasing for fixed-dose combinations and diminishing with the increase of cost for the patient. Conclusions: Overall, almost 1 out of 2 prescribed AHT drugs were not dispensed. Until this study, little was known in Portugal about primary adherence. Our findings imply that the potential benefits of AHT therapy cannot be fully realized in this population.
- What people think about medicines and its prescription by doctors: a study in PortugalPublication . Santos, Margarida; Grilo, Ana; Andrade, Graça; Coelho, AndréDespite the general recognition of the benefits of adherence to medical regimes, it has been estimated that 50% of medicines prescribed for long-term illness are not taken as recommended. Adherence is a multidetermined process. The Extended Common‐Sense Model proposes the inclusion of beliefs about medicines as mediators between illness representations and adherence. Stronger beliefs about medicines and their harmful effects have been associated with higher levels of nonadherence. Objective: Explore general beliefs about medicines, and their recommendation by doctors among the Portuguese general population (age > 18 years) who use community pharmacy. Methodology: The two subscales, “general overuse” and general harm”, of the “The Beliefs about Medicines Questionnaire” (BMQ) and a sociodemographic questionnaire were used. IBM SPSS 26 software was used for statistical analysis. Results: A total of 847 Portuguese adults participated, 331 (39,1%) were 25-44 years of age; 427 (50,4%) concluded secondary education, and 198 (23,4%) reported having a chronic condition. The majority of participants endorse the belief that most medicines are addictive, and a large percentage agreed that they are toxic, that doctors overprescribed and could benefit from hearing patients; and that natural remedies are safer than medicines. Differences were found considering age (p=0,093), sex(p=0,08), and having active working (p=0,045) with stronger beliefs in young adults and adults, in males and no active workers. No differences were found considering the presence/absence of chronic disease". These results are discussed considering their possible contribution to the promotion of adherence through better communication with doctors, nurses, and pharmacists.
- Public information on medication safety: sources, perceived reliability and the influence of educational levelPublication . Andrade, Graça; Grilo, Ana; Santos, Margarida; Coelho, AndréBackground: WHO declared medication safety (MS) a patient safety global concern, placing patient engagement as the centerpiece. Most health psychology models enhance beliefs' influence on health behaviors, being an information-processing determinant of health beliefs. This process it’s influenced by meanings given to information and its sources. Aims: To identify the main information sources about MS, focusing on the Portuguese medicine agency (INFARMED), and assess their perceived reliability and efficacy in transmitting information to the public, considering educational level. Methodology: Data was collected using a convenience sample of 782 participants, who completed a questionnaire assessing sociodemographic data and perceptions about public information on MS. Study was approved by University Ethics Committee. Results: Pharmacies, doctors, INFARMED and Google represent the top-4 sources of information. Only Google is perceived as non-reliable. 7.7% of the participants never heard about INFARMED, with lower frequencies in higher educational levels (p=0.007). The majority of participants consider INFARMED a reliable source and effective in transmitting information about MS, but its perceived efficacy reduces with increased education levels (p<0.001). The same for the impact of more information in raising confidence in medicines (p=0.05). Stop taking the medicine and searching for more information are the most commonly reported consequences of receiving information about a MS problem, with higher frequencies on the lowest education level (p<0.001). Conclusion: Public sources of information are well known and seen as credible, though educated participants seem to be more demanding of the quality and reliability of the information.