Acceptability of non-drug therapies in older people with orthostatic hypotension: a qualitative study
Abstract Background Orthostatic hypotension (OH) is highly prevalent in older populations. It is associated with a reduced quality of life and an increased risk of dementia, stroke and death. Non-pharmalogical therapies are the recommended first-line therapy and are preferred to drug treatments by o...
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| Format: | Article |
| Language: | English |
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BMC
2018-12-01
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| Series: | BMC Geriatrics |
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| Online Access: | http://link.springer.com/article/10.1186/s12877-018-0999-5 |
| _version_ | 1819063262128373760 |
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| author | Lisa J. Robinson Ruth M. Pearce James Frith |
| author_facet | Lisa J. Robinson Ruth M. Pearce James Frith |
| author_sort | Lisa J. Robinson |
| collection | DOAJ |
| description | Abstract Background Orthostatic hypotension (OH) is highly prevalent in older populations. It is associated with a reduced quality of life and an increased risk of dementia, stroke and death. Non-pharmalogical therapies are the recommended first-line therapy and are preferred to drug treatments by older people. However, uptake and adherence is low and evidence for their use is lacking. Objective: Determine the acceptability of non-pharmalogical interventions for OH in older people. Methods This qualitative study, nested within a phase II efficacy study, recruited 25 people aged over 60 years from a Falls and Syncope Clinic. All participants had experienced the following non-pharmalogical therapies within a phase II study: bolus water drinking, compression stockings, abdominal compression, physical counter-manoeuvres. Individual semi-structured qualitative interviews were recorded and transcribed verbatim. Emergent themes were identified through framework analysis of transcripts. Results Physical counter-manoeuvres were considered the most acceptable therapy as no equipment is required, they can be performed discreetly and are only required during postural change. Bolus water drinking was mostly considered as an acceptable therapy, although there were significant concerns around urinary frequency. The idea of bolus water drinking was a barrier to its uptake, but once experienced it was easier than anticipated. Participants had mixed views on acceptability of abdominal compression whereas compression stockings were considered unacceptable by the majority of participants. This was due to the practicalities of applying/removing the compression and the stigma attached to their appearance. Conclusions Current first-line treatment with compression stockings is largely unacceptable to older people with OH, challenging current guidelines. In order to promote uptake and adherence, first line therapy should focus on bolus-water drinking and physical counter-manoeuvres. |
| first_indexed | 2024-12-21T15:11:52Z |
| format | Article |
| id | doaj.art-47de90382fcb49edbc8e58ba43a937f2 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-21T15:11:52Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-47de90382fcb49edbc8e58ba43a937f22022-12-21T18:59:15ZengBMCBMC Geriatrics1471-23182018-12-011811810.1186/s12877-018-0999-5Acceptability of non-drug therapies in older people with orthostatic hypotension: a qualitative studyLisa J. Robinson0Ruth M. Pearce1James Frith2The Falls and Syncope Service, Newcastle upon Tyne Hospitals NHS Foundation TrustInstitute of Cellular Medicine, Newcastle UniversityThe Falls and Syncope Service, Newcastle upon Tyne Hospitals NHS Foundation TrustAbstract Background Orthostatic hypotension (OH) is highly prevalent in older populations. It is associated with a reduced quality of life and an increased risk of dementia, stroke and death. Non-pharmalogical therapies are the recommended first-line therapy and are preferred to drug treatments by older people. However, uptake and adherence is low and evidence for their use is lacking. Objective: Determine the acceptability of non-pharmalogical interventions for OH in older people. Methods This qualitative study, nested within a phase II efficacy study, recruited 25 people aged over 60 years from a Falls and Syncope Clinic. All participants had experienced the following non-pharmalogical therapies within a phase II study: bolus water drinking, compression stockings, abdominal compression, physical counter-manoeuvres. Individual semi-structured qualitative interviews were recorded and transcribed verbatim. Emergent themes were identified through framework analysis of transcripts. Results Physical counter-manoeuvres were considered the most acceptable therapy as no equipment is required, they can be performed discreetly and are only required during postural change. Bolus water drinking was mostly considered as an acceptable therapy, although there were significant concerns around urinary frequency. The idea of bolus water drinking was a barrier to its uptake, but once experienced it was easier than anticipated. Participants had mixed views on acceptability of abdominal compression whereas compression stockings were considered unacceptable by the majority of participants. This was due to the practicalities of applying/removing the compression and the stigma attached to their appearance. Conclusions Current first-line treatment with compression stockings is largely unacceptable to older people with OH, challenging current guidelines. In order to promote uptake and adherence, first line therapy should focus on bolus-water drinking and physical counter-manoeuvres.http://link.springer.com/article/10.1186/s12877-018-0999-5Orthostatic hypotensionAcceptability of healthcareQualitative researchConservative treatment |
| spellingShingle | Lisa J. Robinson Ruth M. Pearce James Frith Acceptability of non-drug therapies in older people with orthostatic hypotension: a qualitative study BMC Geriatrics Orthostatic hypotension Acceptability of healthcare Qualitative research Conservative treatment |
| title | Acceptability of non-drug therapies in older people with orthostatic hypotension: a qualitative study |
| title_full | Acceptability of non-drug therapies in older people with orthostatic hypotension: a qualitative study |
| title_fullStr | Acceptability of non-drug therapies in older people with orthostatic hypotension: a qualitative study |
| title_full_unstemmed | Acceptability of non-drug therapies in older people with orthostatic hypotension: a qualitative study |
| title_short | Acceptability of non-drug therapies in older people with orthostatic hypotension: a qualitative study |
| title_sort | acceptability of non drug therapies in older people with orthostatic hypotension a qualitative study |
| topic | Orthostatic hypotension Acceptability of healthcare Qualitative research Conservative treatment |
| url | http://link.springer.com/article/10.1186/s12877-018-0999-5 |
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