Skip to main navigation menu Skip to main content Skip to site footer

Medicine

Vol 9 No 1 (2024): June

Critical Knowledge Gaps in Iraqi Nurses' Understanding of Antihypertensive Drug Risks
Kesenjangan Pengetahuan Kritis dalam Pemahaman Perawat Irak tentang Risiko Obat Antihipertensi



(*) Corresponding Author
DOI
https://doi.org/10.21070/acopen.9.2024.9284
Published
June 22, 2024

Abstract

Background: Poor adherence to antihypertensive medications and persistently elevated blood pressure contribute significantly to cardiovascular events, increased hospitalizations, and premature mortality. Specific Background: Adverse effects of antihypertensive medications, such as cough, dizziness, and increased urination, often lead to non-adherence, exacerbating these health risks. Knowledge Gap: There is limited understanding of nurses' knowledge regarding the adverse effects of antihypertensive medications, particularly in developing regions. Aims: This cross-sectional study aimed to evaluate the knowledge of nurses in Basra, Iraq, about the adverse effects of antihypertensive medications and to identify areas needing improvement. Results: Seventy nurses (both male and female) from various hospitals in Basra participated in a questionnaire. Findings revealed that only 49.78% of nurses were confident in their knowledge about the adverse effects of these medications, 20% did not know the answers, and 25.9% were unsure. The overall mean score was significant (2.27), indicating insufficient knowledge. Novelty: This study provides the first detailed assessment of nurses' understanding of antihypertensive medication adverse effects in Basra, highlighting a critical gap in knowledge and the need for targeted educational interventions. Implications: Enhancing academic and practical training for nurses is essential to improve patient care and adherence to hypertension treatments. Future research should focus on developing and implementing educational programs and continuous assessment frameworks to ensure nurses are well-equipped to manage and communicate the adverse effects of antihypertensive medications. By addressing these gaps, healthcare providers can better support patients in adhering to their treatment regimens, ultimately reducing cardiovascular risks and improving patient outcomes.

Highlights:

 

  1. Knowledge Gap: Only 49.78% of nurses confident about antihypertensive medication adverse effects.
  2. Implications: Enhance nurse training to improve patient care and treatment adherence.
  3. Future Research: Develop educational interventions and continuous assessment frameworks for nurses.

 

Keywords: Antihypertensive Medications, Nurse Knowledge, Adverse Effects, Hypertension, Patient Adherence

References

  1. R. Chowdhury, H. Khan, E. Heydon, A. Shroufi, S. Fahimi, C. Moore, et al., "Adherence to Cardiovascular Therapy: A Meta-Analysis of Prevalence and Clinical Consequences," Eur. Heart J., vol. 34, no. 38, pp. 2940–2948, 2013.
  2. A. Dragomir, R. Côté, L. Roy, L. Blais, L. Lalonde, A. Bérard, et al., "Impact of Adherence to Antihypertensive Agents on Clinical Outcomes and Hospitalization Costs," Med. Care, vol. 48, no. 5, pp. 418–425, 2010.
  3. World Health Organization, "Prevention of Cardiovascular Disease: Guidelines for Assessment and Management of Cardiovascular Risk," 2007. Available: http://apps.who.int/iris/bitstream/handle/10665/43685/9789241547178_eng.pdf?sequence=1.
  4. World Health Organization, "A Global Brief on Hypertension: Silent Killer, Global Public Health Crisis," 2013. Available: https://www.who.int/cardiovascular_diseases/publications/global_brief_hypertension/en/.
  5. A. V. Chobanian, G. L. Bakris, H. R. Black, W. C. Cushman, L. A. Green, J. L. Izzo Jr., et al., "The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report," JAMA, vol. 289, no. 19, pp. 2560–2571, 2003.
  6. K. P. Lowry, T. K. Dudley, E. Z. Oddone, and H. B. Bosworth, "Intentional and Unintentional Nonadherence to Antihypertensive Medication," Ann. Pharmacother., vol. 39, no. 7–8, pp. 1198–1203, 2005.
  7. H. Black, A. Graff, D. Shute, R. Stoltz, D. Ruff, J. Levine, et al., "Valsartan, a New Angiotensin II Antagonist for the Treatment of Essential Hypertension: Efficacy, Tolerability and Safety Compared to an Angiotensin-Converting Enzyme Inhibitor, Lisinopril," J. Hum. Hypertens., vol. 11, no. 8, pp. 483–489, 1997.
  8. J. D. Curb, N. O. Borhani, T. P. Blaszkowski, N. Zimbaldi, S. Fotiu, and W. Williams, "Long-Term Surveillance for Adverse Effects of Antihypertensive Drugs," JAMA, vol. 253, no. 22, pp. 3263–3268, 1985.
  9. R. Lakhdar, M. H. Al-Mallah, and D. E. Lanfear, "Safety and Tolerability of Angiotensin-Converting Enzyme Inhibitor Versus the Combination of Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker in Patients with Left Ventricular Dysfunction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials," J. Card. Fail., vol. 14, no. 3, pp. 181–188, 2008.
  10. T. Morimoto, T. K. Gandhi, J. M. Fiskio, A. C. Seger, J. W. So, E. F. Cook, et al., "An Evaluation of Risk Factors for Adverse Drug Events Associated with Angiotensin-Converting Enzyme Inhibitors," J. Eval. Clin. Pract., vol. 10, no. 4, pp. 499–509, 2004.
  11. C. Bardage and D. G. Isacson, "Self-Reported Side-Effects of Antihypertensive Drugs: An Epidemiological Study on Prevalence and Impact on Health-State Utility," Blood Press., vol. 9, no. 6, pp. 328–334, 2000.
  12. R. Düsing, B. Weisser, T. Mengden, and H. Vetter, "Changes in Antihypertensive Therapy-The Role of Adverse Effects and Compliance," Blood Press., vol. 7, no. 5–6, pp. 313–315, 1998.
  13. A. E. Fletcher, C. J. Bulpitt, D. M. Chase, W. C. Collins, C. D. Furberg, T. K. Goggin, et al., "Quality of Life with Three Antihypertensive Treatments: Cilazapril, Atenolol, Nifedipine," Hypertension, vol. 19, no. 6, pt. 1, pp. 499–507, 1992.
  14. Z. H. Israili and W. D. Hall, "Cough and Angioneurotic Edema Associated with Angiotensin-Converting Enzyme Inhibitor Therapy," Ann. Intern. Med., vol. 117, no. 3, pp. 234–242, 1992.
  15. E. P. MacCarthy and S. S. Bloomfield, "Labetalol: A Review of Its Pharmacology, Pharmacokinetics, Clinical Uses and Adverse Effects," Pharmacotherapy, vol. 3, no. 4, pp. 193–217, 1983.
  16. F. H. Messerli, "Vasodilatory Edema: A Common Side Effect of Antihypertensive Therapy," Curr. Cardiol. Rep., vol. 4, no. 6, pp. 479–482, 2002.
  17. H. Olsen, T. Klemetsrud, H. P. Stokke, S. Tretli, and A. Westheim, "Adverse Drug Reactions in Current Antihypertensive Therapy: A General Practice Survey of 2586 Patients in Norway," Blood Press., vol. 8, no. 2, pp. 94–101, 1999.
  18. E. Saunders, M. R. Weir, B. W. Kong, J. Hollifield, J. Gray, V. Vertes, et al., "A Comparison of the Efficacy and Safety of a β-Blocker, a Calcium Channel Blocker, and a Converting Enzyme Inhibitor in Hypertensive Blacks," Arch. Intern. Med., vol. 150, no. 8, pp. 1707–1713, 1990.
  19. E. A. Gebreyohannes, A. S. Bhagavathula, T. B. Abebe, et al., "Adverse Effects and Non-Adherence to Antihypertensive Medications in University of Gondar Comprehensive Specialized Hospital," Clin. Hypertens., vol. 25, no. 1, 2019. [Online]. Available: https://doi.org/10.1186/s40885-018-0104-6.
  20. C. Thomopoulos, G. Parati, and A. Zanchetti, "Effects of Blood-Pressure-Lowering Treatment in Hypertension: 9. Discontinuations for Adverse Events Attributed to Different Classes of Antihypertensive Drugs: Meta-Analyses of Randomized Trials," J. Hypertens., vol. 34, pp. 1921-1932, 2016. DOI: 10.1097/HJH.0000000000001052. PMID: 27454050.
  21. L. Frey, I. Gravestock, G. Pichierri, J. Steurer, and J. Burgstaller, "Serious Adverse Events in Patients with Target-Oriented Blood Pressure Management: A Systematic Review," J. Hypertens., vol. 37, pp. 2135-2144, 2019.
  22. A. M. MacConnachie and D. MacLean, "Low Dose Combination Antihypertensive Therapy: Additional Without Additional Adverse Effects?" Drug Safety, vol. 12, pp. 85–90, 1995.
  23. J. M. Flack, C. Yunis, J. Preiser, et al., "The Rapidity of Drug Dose Escalation Influences Blood Pressure Response and Adverse Effects Burden in Patients with Hypertension: The Quinapril Titration Interval Management Evaluation (ATIME) Study," Arch. Intern. Med., vol. 160, pp. 1842–1847, 2000.
  24. W. C. Cushman and H. R. Black, "Hypertension in the Elderly," Cardiol. Clin., vol. 17, pp. 79–92, 1999.
  25. M. Monane, R. Bohn, J. H. Gurwitz, et al., "The Effects of Initial Drug Choice and Comorbidity on Antihypertensive Therapy Compliance: Results from a Population-Based Study in the Elderly," Am. J. Hypertens., vol. 10, pt. 1, pp. 697–704, 1997.
  26. T. K. Gandhi, S. N. Weingart, J. Borus, A. C. Seger, J. Peterson, E. Burdick, et al., "Adverse Drug Events in Ambulatory Care," N. Engl. J. Med., vol. 348, pp. 1556–1564, 2003.
  27. A. O. Olowofela and A. O. Isah, "A Profile of Adverse Effects of Antihypertensive Medicines in a Tertiary Care Clinic in Nigeria," Ann. Afr. Med., vol. 16, no. 3, pp. 114–119, Jul.-Sep. 2017. DOI: 10.4103/aam.aam_6_17. PMID: 28671151; PMCID: PMC5579894.
  28. A. O. Olowofela and A. O. Isah, "A Profile of Adverse Effects of Antihypertensive Medicines in a Tertiary Care Clinic in Nigeria," Ann. Afr. Med., vol. 16, no. 3, pp. 114–119, Jul.-Sep. 2017.
  29. S. P. Bashyal and N. Thapa, "Knowledge and Perception Regarding Hypertension Among Hypertensive Patients at a Tertiary Hospital in Kathmandu, Nepal," J. Adv. Acad. Res., vol. 7, no. 1, pp. 51–62, 2020.
  30. S. Tomasović, J. Sremec, J. Košćak, N. Klepac, P. Draganić, and I. Bielen, "Epidemiological Characteristics of Dementia Treatment in Croatia," Psychiatria Danubina, vol. 28, no. 2, pp. 170–175, 2016.
  31. B. A. Aubert, H. Barki, M. Patry, and V. Roy, "A Multi-Level, Multi-Theory Perspective of Information Technology Implementation," Inf. Syst. J., vol. 18, no. 1, pp. 45–72, 2008.
  32. M. Atiyah, "Nurses’ Knowledge Regarding Management of Hypovolemic Shock: A Cross-Sectional Study," Acopen, vol. 9, no. 2, May 2024. DOI: 10.21070/acopen.9.2024.8925.

Downloads

Download data is not yet available.