Do Patient Preferences and Treatment Beliefs Explain Patterns of Antihypertensive Medication Nonadherence? A Discrete Choice Experiment.

Background: Medication adherence is a critical factor in hypertension management, which remains a challenge for public health systems. Methods: Graded-pair questions were used to quantify the perception of how much nonadherence to antihypertensives increases the risk of serious cardiovascular events...

Descripción completa

Detalles Bibliográficos
Publicado en:Medical Decision Making Vol. 46; no. 1; pp. 47 - 60
Autores principales: Tan, Si Ning Germaine, Muiruri, Charles, Gonzalez Sepulveda, Juan Marcos
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. Jan2026
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=190255136&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 190255136
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        0272989X
        DKI
      jtl: Medical Decision Making
      issn: 0272989X
      maglogo: Y
    pubinfo:
      dt: Jan2026
      vid: 46
      iid: 1
      pid: 344
      pub: Sage Publications Inc.
      place: Thousand Oaks, California
    artinfo:
      ui:
        190255136
        189223173
        190255136
        190255136
        10.1177/0272989X251388046
        190255136
      ppf: 47
      ppct: 13
      formats:
      tig:
        atl: Do Patient Preferences and Treatment Beliefs Explain Patterns of Antihypertensive Medication Nonadherence? A Discrete Choice Experiment.
      aug:
        au:
          Tan, Si Ning Germaine
          Muiruri, Charles
          Gonzalez Sepulveda, Juan Marcos
        affil: Duke-NUS Medical School, Singapore
      sug:
        subj:
          Antihypertensive Agents Therapeutic Use
          Patient Attitudes
          Medication Compliance
          Attitude to Medical Treatment
          Hypertension Drug Therapy
          Cardiovascular Risk Factors
          Human
          Descriptive Statistics
          Confidence Intervals
          Convenience Sample
          Exploratory Research
          Male
          Female
          Interviews
          Random Assignment
          Adult
          Middle Age
          Aged
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background: Medication adherence is a critical factor in hypertension management, which remains a challenge for public health systems. Methods: Graded-pair questions were used to quantify the perception of how much nonadherence to antihypertensives increases the risk of serious cardiovascular events. A discrete-choice experiment was used to quantify the relative importance of medication outcomes (e.g., reduction in cardiovascular event risk and medication side effects). Rating questions were used to assess perspectives of the effect of treatment nonadherence on treatment side effects. Results were combined to assess how preferences and outcome expectations influence adherence. Results: Patients perceived treatment adherence as the most significant contributor to cardiovascular event risk. A reduction in cardiovascular risk was the most significant consideration when choosing medication. Missing consecutive (v. alternate) doses was associated with greater perceived cardiovascular risk and fewer side effects. The differences between complete adherence and any level of nonadherence were significantly larger for side effects than for changes in the risk of cardiovascular events, suggesting that side effects are perceived to be more sensitive to nonadherence than treatment efficacy. Limitations: Our study relied on hypothetical scenarios, which may not fully capture real-world decision making. While our findings shed light on the relationship between adherence patterns and treatment perceptions, it is essential to recognize the complexity of adherence behavior. Conclusions: Patients believe that they can manage medication side effects by skipping doses without compromising the efficacy to the same degree and that they can offset compromises in efficacy by avoiding missing consecutive doses for prolonged periods. Implications: Health care providers should understand the importance of patient education and counseling to address misconceptions and promote realistic expectations regarding treatment efficacy and the consequences of nonadherence. Highlights: The average patient believes that they can manage medication side effects by skipping doses without compromising the efficacy to the same degree. There is a belief that patients can offset some of the impact of nonadherence on their cardiovascular event risk, particularly if they avoid missing consecutive doses for prolonged periods of time. This highlights the importance of patient education and counseling to address misconceptions and promote realistic expectations regarding treatment efficacy and the consequences of nonadherence.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N