Effect of reminder cards on compliance with antihypertensive medication

Abstract

Objective Poor compliance to antihypertensive medications has been identified as a primary cause of uncontrolled blood pressure (BP), with consequent increases in hypertension‐related morbidity and mortality. Therefore, any measure known to improve compliance should be encouraged. This study assessed the impact of reminder cards on compliance to antihypertensive therapy. Method A field trial was undertaken in pharmacies located in the districts of Lisbon and Porto. Eligible participants comprised those aged 30–74 years, prescribed an angiotensin‐converting enzyme inhibitor (ACEI) in monotherapy, and taken on a once‐daily regimen. Patients were allocated to control group (CG) or intervention group (IG), the latter being provided with a reminder card, an alarm‐type device due to remind the patient of the time to take his medication. Patients were monitored monthly during 3 months for compliance and blood pressure control. Key findings Seventy‐one patients participated in the study (intervention: 35; control group: 36). Compliance was similar between the groups in the first 2 months of follow‐up (97.1% IG vs 94.9% CG at first follow‐up and 97.5% IG vs 94.2% CG at second follow‐up) and higher in the intervention group at the end of the study (97.3% IG vs 87.3% CG; P = 0.011). There were no mean blood pressure differences between compliant and non‐compliant subjects at the end of the study (P value for differences in systolic BP (Psyst) = 0.580; and P value for differences in diastolic BP (Pdlast) = 0.175). Conclusion This small‐scale study indicates a possible positive impact on patients' compliance resulting from the use of reminder cards. However, this needs confirming in larger scale studies with longer monitoring periods.

Primary non-adherence in Portugal: findings and implications

“…The sample had a majority of female patients, consistent with the work by Martins et al [42] on pharmacy users. The mean age was slightly higher than expected, but still in line with published data by Costa et al [43] on patients with chronic conditions visiting pharmacies. Retired people were over-represented, which may be a consequence of responder or selection bias.…”

SMSaúde: Evaluating Mobile Phone Text Reminders to Improve Retention in HIV Care for Patients on Antiretroviral Therapy in Mozambique

“…Similarly, at the start of a study or intervention, patients may be enthusiastic and interested in the novel process (because it is intrinsically pleasing), which could diminish over time as the novelty wanes. 31–34 As a result, longer-term studies of outcomes are needed to evaluate the impact of boredom, or novelty may have on the participants.…”

The effectiveness of interventions using electronic reminders to improve adherence to chronic medication: a systematic review of the literature

“…Six studies exclusively used electronic monitoring, 29 31 33e35 40 four combined electronic monitoring with self-report 30 32 36 39 and one combined electronic monitoring with both pill count and self-report. 28 One study exclusively used pill count, 37 one study assessed bottle weight (medication in soluble form) with self-report. 38 Only three studies followed patients for a period of 6 months or longer.…”

“…Three of them used an ERD that produced both an audible and visual reminder, 33 34 38 the fourth used an ERD that only emitted an audible reminder. 37 The one study that found a subgroup effect evaluated an ERD with an audible reminder. 36 Two studies showed no effects, both of them used an ERD that accommodated blister packs.…”