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Factors affecting adherence to antihypertensive medication in Greece: results from a qualitative study
Vassiliki Tsiantou, Polina Pantzou, Elpida Pavi, et al
Patient Preference and Adherence , 2010, DOI: http://dx.doi.org/10.2147/PPA.S12326
Abstract: ctors affecting adherence to antihypertensive medication in Greece: results from a qualitative study Original Research (5154) Total Article Views Authors: Vassiliki Tsiantou, Polina Pantzou, Elpida Pavi, et al Published Date August 2010 Volume 2010:4 Pages 335 - 343 DOI: http://dx.doi.org/10.2147/PPA.S12326 Vassiliki Tsiantou1, Polina Pantzou2, Elpida Pavi1, George Koulierakis2, John Kyriopoulos1 1Department of Health Economics, National School of Public Health, Athens, Greece; 2Department of Sociology, National School of Public Health, Athens, Greece Introduction: Although hypertension constitutes a major risk factor for cardiovascular morbidity and mortality, research on adherence to antihypertensive treatment has shown that at least 75% of patients are not adherent because of the combined demographic, organizational, psychological, and disease- and medication-related factors. This study aimed to elicit hypertensive patients’ beliefs on hypertension and antihypertensive treatment, and their role to adherence. Methods: Transcripts from semistructured interviews and focus groups were content analyzed to extract participants’ beliefs about hypertension and antihypertensive treatment, and attitudes toward patient–physician and patient–pharmacist relationships. Results: Hypertension was considered a very serious disease, responsible for stroke and myocardial infarction. Participants expressed concerns regarding the use of medicines and the adverse drug reactions. Previous experience with hypertension, fear of complications, systematic disease management, acceptance of hypertension as a chronic disease, incorporation of the role of the patient and a more personal relationship with the doctor facilitated adherence to the treatment. On the other hand, some patients discontinued treatment when they believed that they had controlled their blood pressure. Conclusion: Cognitive and communication factors affect medication adherence. Results could be used to develop intervention techniques to improve medication adherence.
Factors affecting adherence to antihypertensive medication in Greece: results from a qualitative study  [cached]
Vassiliki Tsiantou,Polina Pantzou,Elpida Pavi,et al
Patient Preference and Adherence , 2010,
Abstract: Vassiliki Tsiantou1, Polina Pantzou2, Elpida Pavi1, George Koulierakis2, John Kyriopoulos11Department of Health Economics, National School of Public Health, Athens, Greece; 2Department of Sociology, National School of Public Health, Athens, GreeceIntroduction: Although hypertension constitutes a major risk factor for cardiovascular morbidity and mortality, research on adherence to antihypertensive treatment has shown that at least 75% of patients are not adherent because of the combined demographic, organizational, psychological, and disease- and medication-related factors. This study aimed to elicit hypertensive patients’ beliefs on hypertension and antihypertensive treatment, and their role to adherence.Methods: Transcripts from semistructured interviews and focus groups were content analyzed to extract participants’ beliefs about hypertension and antihypertensive treatment, and attitudes toward patient–physician and patient–pharmacist relationships.Results: Hypertension was considered a very serious disease, responsible for stroke and myocardial infarction. Participants expressed concerns regarding the use of medicines and the adverse drug reactions. Previous experience with hypertension, fear of complications, systematic disease management, acceptance of hypertension as a chronic disease, incorporation of the role of the patient and a more personal relationship with the doctor facilitated adherence to the treatment. On the other hand, some patients discontinued treatment when they believed that they had controlled their blood pressure.Conclusion: Cognitive and communication factors affect medication adherence. Results could be used to develop intervention techniques to improve medication adherence.Keywords: hypertension, medication adherence, patient compliance, doctor–patient communication, antihypertensive medicine
Heavy Metal Levels in Saudi Arabian Spirulina  [PDF]
Ali A. Al-Homaidan
Pakistan Journal of Biological Sciences , 2006,
Abstract: A small farm of the microalga Spirulina platensis (Nordstedt) Geitler was established in Saudi Arabia in 1999. The levels of arsenic (As), cadmium (Cd), copper (Cu), iron (Fe), mercury (Hg), manganese (Mn), lead (Pb) and zinc (Zn) were measured in the final dry powder of this alga using atomic absorption spectroscopy. The content of As, Cd, Hg and Pb in the dry powder were very low and they ranged between 0.002 mg kg-1 for As and 0.109 mg kg-1 for Pb. Higher levels were found for Cu, Fe, Mn and Zn and they varied between 8.51 mg kg-1 for Cu and 394 mg kg-1 for Fe. The results indicated that the heavy metal content of Saudi Arabian Spirulina is within the recommended range established by major producers.
Eurasian and African mitochondrial DNA influences in the Saudi Arabian population
Khaled K Abu-Amero, Ana M González, Jose M Larruga, Thomas M Bosley, Vicente M Cabrera
BMC Evolutionary Biology , 2007, DOI: 10.1186/1471-2148-7-32
Abstract: The Saudi Arabian group showed greatest similarity to other Arabian Peninsula populations (Bedouin from the Negev desert and Yemeni) and to Levantine populations. Nearly all the main western Asia haplogroups were detected in the Saudi sample, including the rare U9 clade. Saudi Arabs had only a minority sub-Saharan Africa component (7%), similar to the specific North-African contribution (5%). In addition, a small Indian influence (3%) was also detected.The majority of the Saudi-Arab mitochondrial DNA lineages (85%) have a western Asia provenance. Although the still large confidence intervals, the coalescence and phylogeography of (preHV)1 haplogroup (accounting for 18 % of Saudi Arabian lineages) matches a Neolithic expansion in Saudi Arabia.This study represents mtDNA data regarding the population of Saudi Arabia. Geographically, desert is the most prominent feature of the Arabian Peninsula, which comprises the modern countries of Saudi Arabia, Yemen, Oman, the United Arab Emirates, Qatar, Bahrain, and Kuwait. Saudi Arabia occupies eighty percent of the Arabian Peninsula and is divided into five major regions – Central, Northern, Southern, Eastern and Western. From the western coastal region (At-Tihamah), the land rises from sea level to a peninsula-long mountain range (jabal al-Hijaz) beyond which are plateaus to the east. The southwestern 'Asir region has mountains as high as 3,000 metres (9,840 ft) and is known for having the most hospitable climate in the country. The east is primarily rocky or sandy lowland continuing to the shores of the Arabian Gulf. Although vast arid tracts dominate, stretches of coastline along the Arabian Gulf and the Red Sea and several major oases in the central and eastern regions have provided water necessary for human habitation. The coastal areas have been trading centers for centuries with resultant population diversity. In addition, for 1400 years the Haj has brought millions of Muslims annually to the region between Mecca and Je
Patient adherence and the choice of antihypertensive drugs: focus on lercanidipine  [cached]
Menno T Pruijm,Marc P Maillard,Michel Burnier
Vascular Health and Risk Management , 2008,
Abstract: Menno T Pruijm, Marc P Maillard, Michel BurnierService of Nephrology and Hypertension, Department of Medicine, University Hospital, Lausanne, SwitzerlandAbstract: Despite the development of many effective antihypertensive drugs, target blood pressures are reached in only a minority of patients in clinical practice. Poor adherence to drug therapy and the occurrence of side effects are among the main reasons commonly reported by patients and physicians to explain the poor results of actual antihypertensive therapies. The development of new effective antihypertensive agents with an improved tolerability profile might help to partly overcome these problems. Lercanidipine is an effective dihydropyridine calcium channel blocker of the third generation characterized by a long half-life and its lipophylicity. In contrast to first-generation dihydropyridines, lercanidipine does not induce reflex tachycardia and induces peripheral edema with a lower incidence. Recent data suggest that in addition to lowering blood pressure, lercanidipine might have some renal protective properties. In this review we shall discuss the problems of drug adherence in the management of hypertension with a special emphasis on lercanidipine.Keywords: compliance, hypertension, calcium antagonists
Can adherence to antihypertensive therapy be used to promote adherence to statin therapy?
Richard H Chapman, Elise M Pelletier, Paula J Smith, et al
Patient Preference and Adherence , 2009, DOI: http://dx.doi.org/10.2147/PPA.S5868
Abstract: n adherence to antihypertensive therapy be used to promote adherence to statin therapy? Original Research (5783) Total Article Views Authors: Richard H Chapman, Elise M Pelletier, Paula J Smith, et al Published Date August 2009 Volume 2009:3 Pages 265 - 275 DOI: http://dx.doi.org/10.2147/PPA.S5868 Richard H Chapman1, Elise M Pelletier1, Paula J Smith1, Craig S Roberts2 1US Health Economics and Outcomes Research, IMS Health, Falls Church, VA, USA; 2Global Outcomes Research, Pfizer Inc, New York, NY, USA Objective: To compare adherence with statin therapy in patients switching to single-pill amlodipine besylate/atorvastatin calcium with patients adding a separate statin to their amlodipine regimen. Methods: We identified hypertensive patients prescribed amlodipine who switched to amlodipine/atorvastatin (switch) or added a statin to their amlodipine regimen (add-on) from July 2004 to June 2007. Propensity score matching (1 switch:3 add-on) was applied based on ‘nearest neighbor’ approach. The primary adherence measure was patients with proportion of days covered (PDC) ≥0.80 at 180 days; secondary measures included mean PDC and persistence. A sensitivity analysis was performed, accounting for total statin/amlodipine exposure. Results: Among 4556 matched patients (n = 1139 switch; n = 3417 add-on), mean age was 53.9 years and 52.1% were male. After 180 days, adherence with statin therapy was higher for the switch vs add-on cohort (50.8% vs 44.3%; P < 0.001). After adjusting for pre-index amlodipine adherence, the switch cohort was more likely to be adherent than the add-on cohort (odds ratio: 1.64 [95% confidence interval: 1.42 to 1.89]). Persistence was higher in the switch than the add-on cohort (127.6 vs 117 days; P < 0.001). Conclusion: Hypertensive patients taking amlodipine who initiated statin therapy via single-pill amlodipine/atorvastatin were more likely to remain adherent to their statin than patients adding a separate statin to their antihypertensive regimen.
Can adherence to antihypertensive therapy be used to promote adherence to statin therapy?  [cached]
Richard H Chapman,Elise M Pelletier,Paula J Smith,et al
Patient Preference and Adherence , 2009,
Abstract: Richard H Chapman1, Elise M Pelletier1, Paula J Smith1, Craig S Roberts21US Health Economics and Outcomes Research, IMS Health, Falls Church, VA, USA; 2Global Outcomes Research, Pfizer Inc, New York, NY, USAObjective: To compare adherence with statin therapy in patients switching to single-pill amlodipine besylate/atorvastatin calcium with patients adding a separate statin to their amlodipine regimen.Methods: We identified hypertensive patients prescribed amlodipine who switched to amlodipine/atorvastatin (switch) or added a statin to their amlodipine regimen (add-on) from July 2004 to June 2007. Propensity score matching (1 switch:3 add-on) was applied based on ‘nearest neighbor’ approach. The primary adherence measure was patients with proportion of days covered (PDC) ≥0.80 at 180 days; secondary measures included mean PDC and persistence. A sensitivity analysis was performed, accounting for total statin/amlodipine exposure.Results: Among 4556 matched patients (n = 1139 switch; n = 3417 add-on), mean age was 53.9 years and 52.1% were male. After 180 days, adherence with statin therapy was higher for the switch vs add-on cohort (50.8% vs 44.3%; P < 0.001). After adjusting for pre-index amlodipine adherence, the switch cohort was more likely to be adherent than the add-on cohort (odds ratio: 1.64 [95% confidence interval: 1.42 to 1.89]). Persistence was higher in the switch than the add-on cohort (127.6 vs 117 days; P < 0.001).Conclusion: Hypertensive patients taking amlodipine who initiated statin therapy via single-pill amlodipine/atorvastatin were more likely to remain adherent to their statin than patients adding a separate statin to their antihypertensive regimen.Keywords: adherence, amlodipine, atorvastatin, cardiovascular disease, persistence, single-pill
Anthropological approach of adherence factors for antihypertensive drugs  [PDF]
Sarrandon-Eck A,Egrot M,Blanc M-A,Faure M
Pratiques et Organisation des Soins , 2008,
Abstract: SummaryAim: Uncontrolled hight blood pressure leads clinicians to wonder about adherence degree amongst hypertensive patients. In this context, our study aims to describe and analyse patients experience of antihypertensive drugs, in order to shed light on the multiple social and symbolic logics, forming part of the cultural factors shaping personal medication practices.Methods: The inductive and comprehensive anthropological approach implemented is based on an ethnographical survey (observations of medical consultations and interviews). Semi-structured interviews were conducted with 68 hypertensive patients (39 women and 29 men,between the ages of 40 and 95, of whom 52 were over 60) who had been receiving treatment for over a year. Results: Antihypertensive drug is reinterpreted using popular representations of pathophysiology (the body as a machine). This symbolic dimension eases acceptance of therapy, but leads to a hierarchy forming of other prescribed medicines and of certain therapeutic classes(such as diuretics). Prescription compliance does not solely depend on the patient’s perception of cardiovascular risk, but also on how the patient appropriates the treatment and integrates it into his/her daily life, requiring identification with the product,building commitment and self-control of the treatment(experimentation; command of treatment; control of side effects, of intake, continuity of treatment).A relationship based on trust between the physician and patient is necessary for a prescription to be followed. We have identified three types of relationship: reasoned trust, emotional trust, conceded trust.Conclusion: Consideration and understanding of these pragmatic, symbolic issues by physicians should help practitioners support and advise patients with high blood pressure.Prat Organ Soins 2008;39(1):3-12
Saudi Arabian Humanitarian Aid in Crises Management Periods  [PDF]
Hassen Altalhi
Open Journal of Political Science (OJPS) , 2017, DOI: 10.4236/ojps.2017.73031
Abstract: Saudi Arabia is among the first countries in the world to develop global programs for providing humanitarian aid of relief to communities stricken by natural and manmade disasters or regions severely impacted by catastrophic wars. The government of Saudi Arabia provides such humanitarian aid through the auspices of the United Nations and other official organizations such as the World Bank and nongovernmental organizations (NGOs). The Saudi humanitarian support is not limited only to Arab and Muslim countries, but is extended internationally regardless of nationality and cultural differences. Saudi Arabia does not merely provide humanitarian aid for recovery from natural disasters, but also supplies donations in the form of cash or developing projects to developing countries, impacted by critical disasters such as drought and poverty. Saudi Arabia performs or provides free medical assistance for children in various parts of the world and has earned the characterization “Kingdom of Humanity” due to these initiatives. The present study summarizes the contributions of Saudi Arabia to humanitarian relief.The study entailed the use of available data collected from various sources that have been used in former research for the period of (2005-2015).
Saudi Arabian Y-Chromosome diversity and its relationship with nearby regions
Khaled K Abu-Amero, Ali Hellani, Ana M González, Jose M Larruga, Vicente M Cabrera, Peter A Underhill
BMC Genetics , 2009, DOI: 10.1186/1471-2156-10-59
Abstract: Saudi Arabia differentiates from other Arabian Peninsula countries by a higher presence of J2-M172 lineages. It is significantly different from Yemen mainly due to a comparative reduction of sub-Saharan Africa E1-M123 and Levantine J1-M267 male lineages. Around 14% of the Saudi Arabia Y-chromosome pool is typical of African biogeographic ancestry, 17% arrived to the area from the East across Iran, while the remainder 69% could be considered of direct or indirect Levantine ascription. Interestingly, basal E-M96* (n = 2) and J-M304* (n = 3) lineages have been detected, for the first time, in the Arabian Peninsula. Coalescence time for the most prominent J1-M267 haplogroup in Saudi Arabia (11.6 ± 1.9 ky) is similar to that obtained previously for Yemen (11.3 ± 2) but significantly older that those estimated for Qatar (7.3 ± 1.8) and UAE (6.8 ± 1.5).The Y-chromosome genetic structure of the Arabian Peninsula seems to be mainly modulated by geography. The data confirm that this area has mainly been a recipient of gene flow from its African and Asian surrounding areas, probably mainly since the last Glacial maximum onwards. Although rare deep rooting lineages for Y-chromosome haplogroups E and J have been detected, the presence of more basal clades supportive of the southern exit route of modern humans to Eurasian, were not found.The arid Arabian Peninsula can be viewed as a geographic cul de sac and passive recipient of Near East cultural and demic expansions since the Bronze Age. However, southern Arabian late Neolithic excavations revealing sorghum and date palm cultivation attest to earlier influences from East Africa and South western Asia [1]. However, after the southern dispersal route of modern humans across the Bab el Mandeb Strait was proposed [2] and further developed [3], multidisciplinary interest on this region has dramatically increased in the search for traces of such putative early southern dispersals across the Arabian threshold. From an archaeological p
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