Physician and patient views regarding antihypertensive drug side effects

Abstract

Differences in physicians' and patients' perceptions of the seriousness of antihypertensive drug side effects were examined among a sample of 103 physicians and 100 hypertensive out-patients. Possible rationales behind physicians' and patients' value judgments were also explored in this study. The first hypothesis stated that, overall, patients would rate the seriousness of antihypertensive drug side effects higher than physicians would. The second hypothesis stated that physicians who evidence an approach to antihypertensive treatment which places greater emphasis on patient involvement in the therapeutic process, would demonstrate a greater willingness to modify a drug regimen if side effects were reported. The third hypothesis stated that patients who have appropriate health beliefs concerning hypertension and its treatment, will generally rate the side effects as being less serious compared to patients who do not hold these beliefs.;Using a self-report questionnaire, physicians rated the seriousness of 64 possible drug side effects according to how bothersome a patient would have to report each symptom to be before they would modify the regimen. Patients rated the seriousness of these same side effects according to how bothersome each symptom would have to be for them to want their doctor to change the regimen in some way. Additionally, physicians completed a questionnaire which examined their attitudes toward the treatment of hypertension, and patients completed a questionnaire which measured their health beliefs about hypertension.;Only the second hypothesis was supported by the data (r = 0.215, p = 0.03). However, a number of significant secondary findings emerged. Patients' perceptions of the seriousness of antihypertensive drug side effects varied inversely with the number of other conditions for which they were being treated. Physicians with more years of clinical experience evidenced attitudes toward treatment which were more conducive to patient involvement. Also, results of multiple comparisons between physicians and patients for the side effects individually, showed that approximately 33% of the side effects were considered more serious by patients and that approximately 16% of the side effects were determined to be more serious by physicians. Possible clinical implications of these findings and suggestions for further research are discussed.