Bulpitt and Fletcher (1988)

Aims

To review research on non-adherence in patients who were given medication to regulate hypertension.

Procedures

Review article of range of research, which identified problems with taking medication for high blood pressure.

Tried to identify:

• The physical side effects
• The psychological effects
• Problems at work
• Effects of physical well-being.

Findings

Anti-hypertensive drugs have many side effects:

• Sleepiness
• Laziness
• Impotence 
• Dizziness
• Weakened cognitive functions – work and hobbies could be curtailed.

Conclusions

When the costs of taking medication (side effects) outweigh the benefits of treating the problem, mainly an asymptomatic one, patients are less likely to adhere to the treatment.

Men are more likely to reject due to the negative impact on sexual performance.

Strengths:

• Useful – the research is useful because it enables to look at patterns and see if attitudes towards medication and adherence change over time.
• Cross-referencing – different pieces of research were used, allowing for cross-referencing, which increases the reliability of results as well as the generalisability. This is because the findings are likely to be repeated if the research was replicated and the more articles, the more participants.
• Holistic – the research looked at both psychological and physical effects of the medication, making the analysis more holistic. This makes the findings more realistic.

Weaknesses:

• Lack of temporal validity – the research was dated; therefore, it may lack temporal validity since results may not be the same if the research was replicated.
• Lack of internal validity – it is unknown what the depth and validity of the research was, and the article is fairly brief, therefore we cannot say that the results were valid.
• Low reliability – the methods used in the research are unknown, making the results have low reliability since biases, social desirability and demand characteristic may have affected the original answers of participants.