PRACTICE ON QUANTITATIVE CRITIQUE: LITERATURE REVIEW AND STUDY DESIGN

Article title: “Health-related quality of life and antihypertensive medication adherence among older adults”

Authors: Elizabeth, W.H, Paul M, Cara J.J, Larry W, and Marie, A. K.W

            Hypertension is one of the prevalent and symptomatic ailments that have the ability of affecting thousands of adults. Despite the effective curative treatments as well as the evidence-based treatment guidelines that are used for the purpose of managing or controlling high blood pressure, the truth is that uncontrolled hypertension is one of the challenges facing modern therapeutic procedures.  Taking into consideration the views of the author, it is evident that low antihypertensive clinical attention has been perceived to be one of the important barriers that limit the control of hypertension.

             Moreover, behavioral, treatment, clinical, and demographic factors are also some of the agents that are ultimately associated with its medication adherence. The reason for that is because this study suggests that some of the psychosocial factors are the ones which assist in determining the extent of antihypertensive therapeutic adherences in aging individuals.  Despite that, the effects that it induces on the mental and physical quality of life of an individual is one of the mechanisms that are used to access the manner in which their psycho-ability have the potential of managing their chronic diseases. 

            According to this article, it is clear that some of the results obtained from the subgroup assessment indicate that the association between antihypertensive medication and HRQOL adherence remain to be consistent across gender, race, and age groups.  Furthermore, the modern research carried concerning this ailment indicates that individuals with low MCS and PCS HRQOL scores have the propensity of having medium o low antihypertensive medication adherences, even after making adjustments for education, race, age, marital status, and gender. This then implies that the association that exists between these factors is perceived to be consistent and persistent in subgroup examinations. On the other hand, the authors suggest that the information obtained reveals that there is a consistent relationship which exists between mental and physical measures of antihypertensive and HRQOL medication adherence in aging individuals. Regardless of that, some of the researches that aid evaluating such a relationship have ended up producing extensive conflicting results. Taking into account the sample of geriatric patients who were used in assessing this claim, it is evident that there was no any relationship that can be detected between self-reported and HEQOL antihypertensive individuals with an age ranging from 35-80 years. The reason for that is because weak negative link can easily be indentified between HRQOL and the self-reported treatment. With respect to the views of the author, it is logical to say that aging individuals having low MCS scores have the potential of showing minimal adherences to their antihypertensive treatment or medication.

            Nevertheless, as far as hypertension in adults is concerned, it is evident that HRQOL that is ultimately associated with lower antihypertensive treatment adherences ought to take into account the attitudes of the patients towards accepting the medical attention given as well as their psychosocial wellbeing.  This means that the exact mechanism that assists in associating HRQOL with the medication provided to such individuals still remains unknown. Despite that, it has been proven that HRQOL is one of the complex web of psychosocial characteristics that have the ability of negatively impacting the aptitude of the patient o manage some of their chronic diseases.

            Taking into account the results obtained from patients suffering from diabetes, it has been found that HRQOL can also be associated with a variety of factors. This is because these factors have been regarded as being the main precursors to therapeutic adherences, including the beliefs of the patients that they can have the ability of controlling their self-efficacy or behaviors, their knowledge and attitude towards disease management, their competence levels, as well as their optimism or outlook of life. Thus, other than what the article suggests, it is important to carry out extra researches which assist in understanding all the mechanisms HRQOL uses in affecting the adherence to antihypertensive treatments as well as in cardiovascular health.

            According to this article, the result obtained from the research conducted suggests that mental and physical measures or scores of HRQOL are ultimately linked with its medication adherences, especially in emotional, social, and mental domains. Although these results comply with the information that was obtained from the previous studies, it is important to first identify some of the medical depressions a person has. Ideally, it is these assumptions that can aid in evaluating some of the depressive symptoms that examine how antihypertensive treatment adherence correlates in patients suffering from chronic disease.

            From the information collected using patients who acknowledged that they always felt worn out and tired most of the time, implied that they have frequent interferences with their normal societal activities. The main cause of that is because of the emotional and depression problems and the feeling of nervousness that they develop. As a result of that, they end up increasing the odds of low antihypertensive therapeutic adherence. This then implies that older individuals suffering from hypertension as well as having worsening emotional wellbeing might have low adherences to antihypertensive medication.

            As the authors continue to express their views, they suggest that aging individuals having low mental and physical HRQOL have the likelihood of having low adherences to such treatment, whether such an adherences was measures using pharmacy or self-reported means. Despite that, it is logical to say that HRQOL is one of the important factors that can assist in understanding an individual’s adherence to antihypertensive medications, with social, emotional, and mental domains generating the greatest impact. In order to make this possible, it is important to clarify the longitudinal relationship that exist between antihypertensive treatment adherences, health outcomes, and HRQOL in aging individuals. The reason for that is because it will aid physicians to assess whether improvement in an individual’s quality of life has the ability of increasing adherence to antihypertensive medications as well as improvement in cardiovascular health results.

            Nevertheless, the effective prevention and management of cardiovascular events in individuals suffering from hypertension mainly require optimal control of their blood pressure levels. Regardless of the advances in its management and prevention, poor antihypertensive medication adherences are also one of the factors that attenuate its treatment efficacy. This implies that medication adherences are one of the self-regulatory behaviors in an individual. As the authors continue to explain in this article, the majority of people always strive to understand their disease or ailment through creating their personal model. Because of that, it becomes possible to conceptualize it as a disease representation.

            There are five main key elements that can be used for the purpose of representing illness. these components include what the disease or the ailment is, the causal factors of such a disease, the effects it has to the daily life of an individual, the duration it takes, as well as whether it is possible to control it. Conversely, the representation of hypertension in adults can also be fostered through using previous symptoms and disease experiences. All this have to be based on the data obtained from different cultural and social associations. Therefore, the uniqueness of its representation is based on the intrinsic beliefs of a person.

            Additionally, the representation of hypertension in an individual is perceived to be dynamic hence has the ability of changing over the course of the ailment.  This means that is the responsibility of an individual to have the ability of determining his or her coping strategies which in return assist in regulating or minimizing their health challenges. A person has the option of either choosing to adhere to the available medication regime by taking into account what they believe to be absolutely true about hypertension. These will have to take into account some of the connections that exist in the process of seeking medical attention to disease management.  As the article suggests, it is evident that it is the continued utilization of the available coping strategies that can assist in appraising its therapeutic outcomes in older people.      Preferably, in case a person feels that these coping strategies do not have the potential of managing hypertension; it implies that they have the likelihood of terminating the medical attention they receive. In the process of ensuring that each person has been informed about the treats of hypertension, it becomes possible to predict its medication adherence. This should also take into account providing education strategies that can assist older adults to cope up with hypertension.