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Family Practice Advance Access published online on August 17, 2005
Family Practice, doi:10.1093/fampra/cmi081
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© The Author (2005). Published by Oxford University Press. All rights reserved.
Received October 4, 2004
Accepted July 6, 2005

Article

What effects do patients feel from their antihypertensive tablets and how do they react to them? Qualitative analysis of interviews with patients

John Benson 1* and Nicky Britten 2

1 University Lecturer in General Practice, General Practice and Primary Care Research Unit, Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 2SR, UK
2 Professor in Applied Healthcare Research, Institute of Health and Social Care Research, Peninsula Medical School, St Lukes Campus, Exeter EX1 2LU, UK

* To whom correspondence should be addressed.
John Benson, E-mail: Jab62{at}medschl.cam.ac.uk


  Abstract

Background. Patients commonly experience palpable effects from antihypertensives. Few studies have examined patients' experiences of these effects and how they influence patients' behaviour and medicine-taking.

Objectives. To describe the palpable effects that patients attribute to their antihypertensive tablets and the ways that they react to them.

Methods. In depth interviews with a maximum variety sample of 38 patients taking antihypertensive medication in 2 mainly urban UK general practices. Qualitative analysis based upon the study's objectives.

Results. Most patients attributed palpable effects to their antihypertensives. Some effects were welcome, attributed to lowered blood pressure or a calming effect of tablets, but others were unwelcome. As a result of these, some patients stopped their tablets, but more continued taking tablets as usual, took their tablets in a different way, or countered unwelcome effects by some other means. Although patients discussed stopping tablets with their doctor, they commonly did not discuss other reactions. Patients who accepted persistent unwelcome effects balanced them against reasons to take medication: positive experiences with doctors; perceived benefits of medication; or pragmatic considerations. These reasons overlap with those described previously as balancing patients' reservations about medicines.

Conclusion. The term ‘side effect’ fails to distinguish between palpable effects that are welcome or unwelcome, or to recognise that some unwelcome effects may nevertheless be acceptable. If clinicians explore the range of palpable effects that patients attribute to antihypertensives and patients' possible preparedness to tolerate unwelcome effects, they will be better able to identify patients' preferences in this area.

Keywords: Hypertension; patient-centred care; prescribing; qualitative research.
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