{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T22:06:19Z","timestamp":1790201179860,"version":"4.1.0"},"reference-count":22,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,2,3]]},"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the level of adherence to angiotensin receptor blockers (ARBs) in patients regularly attending a community pharmacy and the influence of a change in patients' adherence to pharmacological treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study of a random sample of consecutive patients collecting their medication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>40 community pharmacies in Alicante (Southeast Spain).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>602 consecutive \u226518\u2005years old patients following treatment with ARBs at least 3 previous refills were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Prevalence of uncontrolled blood pressure (BP) and adherence to prescribed pharmacological treatment (measured through both the Batalla and the Morisky-Green tests). A multivariate Poisson regression model was used to estimate the adjusted risk ratio (RRa) for non-adherence to pharmacological treatment by the presence of a change in patient's adherence and other significant variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>161\/602 (13.7%) patients presented uncontrolled BP. According to the Morisky test, 410\/602 (68.2%) patients were considered adherent to pharmacological treatment and 231\/602 (38.4%) patients according to the Batalla test. According to the Morisky-Green test, in the multivariable analysis, patients with a previous change in pill appearance were less likely to be adherent than those patients with no change in their pharmacological treatment (RRa 0.45; CI 95% 0.22 to 0.90; p=0.024). Systolic BP was higher in patients with a change in pill appearance in the previous 3 refills (median BP 142\u2005mm\u2005Hg; IQR 136\u2013148) than in those who did not have a change (median BP 127\u2005mm\u2005Hg; IQR 118\u2013135; p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There was a low percentage of adherence and nearly 15% of uncontrolled BP in patients who regularly collected their medication. Switching between pills of different appearances was associated with lower patient adherence to pharmacological treatment and a higher uncontrolled BP than no change in pharmacological treatment or change only in package but not in pill appearance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-012586","type":"journal-article","created":{"date-parts":[[2017,3,31]],"date-time":"2017-03-31T20:10:15Z","timestamp":1490991015000},"page":"e012586","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Impact of changes in pill appearance in the adherence to angiotensin receptor blockers and in the blood pressure levels: a retrospective cohort study"],"prefix":"10.1136","volume":"7","author":[{"given":"B","family":"Lumbreras","sequence":"first","affiliation":[{"name":"Department of Public Health, History of Science and Gynecology, Miguel Hern\u00e1ndez University, Alicante, Spain"},{"name":"CIBER en Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"L\u00f3pez-Pintor","sequence":"additional","affiliation":[{"name":"Department of Engineering, Area of Pharmacy and Pharmaceutical Technologies, Miguel Hern\u00e1ndez University, Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,3,30]]},"reference":[{"key":"2025120521220019000_7.3.e012586.1","unstructured":"National Institute for Health and Clinical Excellence (NICE). 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