Adherence to antihypertensive treatment during the COVID-19 pandemic: findings from a cross-sectional study.

BACKGROUND: Nonadherence to antihypertensive treatment is one of the main causes of the lack of blood pressure (BP) control. The coronavirus disease (COVID-19) pandemic imposes substantial social restriction impairing the medical care routine, which may influence adherence to the antihypertensive treatment. To assess the rate of nonadherence to antihypertensive drug treatment during the COVID-19 pandemic. METHODS: This is a cross-sectional study evaluating hypertensive adult patients from a tertiary outpatient clinic. From March to August 2020, patients were interviewed by telephone during the social distancing period of the COVID-19 pandemic. We evaluated biosocial data, habits, attitudes, and treatment adherence using the 4-item Morisky Green Levine Scale during the social distancing. Uncontrolled BP was defined by BP ≥ 140/90 mmHg. Clinical and prescription variables for drug treatment were obtained from the electronic medical record. We performed a multivariate analysis to determine the predictors of nonadherence to BP treatment. RESULTS: We studied 281 patients (age 66 ± 14 years, 60.5% white, 62.3% women, mean education of 9.0 ± 4 years of study). We found that 41.3% of the individuals reported poor adherence to antihypertensive drug treatment and 48.4% had uncontrolled BP. Subsample data identified that adherence was worse during the pandemic than in the previous period. The variables that were independently associated with the nonadherence during the pandemic period were black skin color (odds ratio [OR], 2.62; 95% confidence interval [CI], 1.46-4.68), and intermittent lack of access to antihypertensive medication during the pandemic (OR, 2.56; 95% CI, 1.11-5.89). CONCLUSIONS: Beyond traditional variables associated with poor adherence, the lack of availability of antihypertensive medications during the study underscore the potential role of pandemic on hypertension burden.

Teleconsultation as an advanced practice nursing during the COVID-19 pandemic based on Roy and Chick-Meleis.

Teleconsultation can be classified as an advanced practice nursing that requires nurses' clinical reasoning based on a consistent theoretical framework to use in the nursing process. Our study conducted a theoretical-reflective analysis, based on Callista Roy's Adaptation Model of Nursing and Chick-Meleis' Transition Theory, about the contribution of teleconsultation as an advanced practice nursing in the care of older adults with chronic diseases during the COVID-19 pandemic. We reflect on this in two moments: "nursing theories and dealing with COVID-19" and "ways of adapting to new care models and advanced practice nursing," based on communication and information technologies. The worsening of the pandemic in Brazil changed life cycles, health/disease and organizational processes, demanding the development of an adaptive-transactional state by users and health care providers. Thus, information and communication technologies combined with advanced practice nursing can relieve social distancing and its repercussions on health care.