Adherence to antihypertensive medications among family practice patients with diabetes mellitus and hypertension.
Bibliographic record
Abstract
OBJECTIVE: To measure adherence and to identify factors associated with adherence to antihypertensive medications in family practice patients with diabetes mellitus (DM) and hypertension. DESIGN: A cross-sectional study using a mailed patient self-report survey and clinical data. SETTING: Twenty-seven family physician and nurse practitioner clinics from Nova Scotia, New Brunswick, and Prince Edward Island (the Maritime Family Practice Research Network). PARTICIPANTS: A total of 527 patients with type 2 DM and hypertension who had had their blood pressure measured with the BpTRU (an automated oscillometric instrument) at family practice clinic visits within the previous 6 months. MAIN OUTCOME MEASURES: Level of adherence to antihypertension medications as measured by patients' self-report on the Morisky scale; association between high adherence on the Morisky scale and 22 patient factors related to demographic characteristics, clinical variables, knowledge, beliefs, behaviour, health care provider relationships, and health system influences. RESULTS: The survey response rate was 89.6%. The average age of patients was 66 years, and 51.6% of participants were men. Forty-three percent of patients had had a diagnosis of DM for more than 10 years, and 49.7% had had a diagnosis of hypertension for more than 10 years. Eighty-nine percent of patients had some form of medical insurance. All patients had seen their family physician providers at least once within the past year. Seventy-seven percent of patients reported high adherence as measured by the Morisky scale. On multiple logistic regression, being older than 55, taking more than 7 prescribed medications, and having a lifestyle that included regular exercise or a healthy diet with low salt intake or both were significant independent predictors of high adherence scores on the Morisky scale (P ≤ .05). CONCLUSION: More than three-quarters of patients with type 2 DM and hypertension from community family practice clinics in Maritime Canada reported high adherence to their antihypertensive medications. Family physicians and nurse practitioners can apply strategies to improve antihypertensive medication adherence among type 2 DM patients who are younger, taking fewer medications, or not maintaining a lifestyle that includes regular exercise or a healthy diet or both. Future studies will need to determine whether focusing adherence strategies on these patients will improve their cardiovascular outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".