Electronic pill-boxes in the evaluation of antihypertensive treatment compliance: comparison of once daily versus twice daily regimen

Andréjak, M.; Genès, N; Vaur, L; Poncelet, Pascal; Clerson, Pierre; Carré, A

doi:10.1016/s0895-7061(99)00175-2

Cited by 76 publications

(55 citation statements)

References 19 publications

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“…23,40 However, some other more recent studies reported compliance rates close to 90%. 46,47 Nuesch et al 47 discussed if higher compliance rates already reflected better acceptance of modern treatment with once daily regimes and comparatively mild side effects. The high compliance rate observed in our study could however be a result of increased awareness for compliance by completing the survey.…”

Section: Compliance In Hypertensive Patientsmentioning

confidence: 99%

The COMpliance PraxiS Survey (COMPASS): a multidimensional instrument to monitor compliance for patients on antihypertensive medication

Schoberberger

Janda

Pescosta³

et al. 2002

J Hum Hypertens

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Low compliance is suspected as a major reason for treatment failure in hypertensive patients. To identify patients with low compliance at the commencement of antihypertensive treatment, the compliance praxis survey (COMPASS) was utilised. A total of 161 physicians identified 2389 hypertensive patients treated by ACEinhibitor. The physicians rated the compliance of the patients at baseline and at 6-month follow-up prospectively. Standard care was given. The mean age of patients was 64.5 years (54.4% women). The baseline overall score of compliance was medium to high in 97.3% of patients. A quarter of all patients (24.7%) were described as having difficulties to follow lifestyle changes, 22.3% lacked sufficient social support, and 31.0% were unwilling to obtain additional information about illness and treatment. Patients who had received prior treatment for cardiovascular disease were less compliant than those who received first treatment within this study (P ¼ 0.05). Younger (Po0.01), male patients (Po0.01), and those without prior cardiovascular disease (Po0.001) were significantly more likely to stop the antihypertensive treatment without a doctor's recommendation. Doctors' rating of compliance at baseline correlated well with ongoing treatment at 6-month follow-up. In conclusion, the COMPASS survey questionnaire is a useful instrument for doctors to differentiate between patients who lack resources and to then counsel patients based on their individual needs.

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Section: Compliance In Hypertensive Patientsmentioning

confidence: 99%

The COMpliance PraxiS Survey (COMPASS): a multidimensional instrument to monitor compliance for patients on antihypertensive medication

Schoberberger

Janda

Pescosta³

et al. 2002

J Hum Hypertens

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“…Pill counts are substantially less useful for assessing adherence in a clinic setting, where prescriptions can be filled at a variety of community pharmacies, and patients do not generally bring their medications to visits. In a research setting, medication containers with microprocessors record each time the container is opened, providing a surrogate measure of medication consumption (22)(23)(24). Notably, the event recorders may not agree fully with patient report of medication adherence (25).…”

mentioning

confidence: 99%

Adherence to Treatment in Children With Epilepsy: Who Follows "Doctor's Orders"?

2000

Epilepsia

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Summary: Purpose:The goal of the present study was to examine sociocultural, medical, family environment, and individual cognitive factors that predict adherence to treatment in children with epilepsy.Methods: The study subjects (4-13 years old) were enrolled in a longitudinal seizure study at the first visit to the seizure clinic, attended at least 6 months, and had at least two appointments. Baseline predictors, which were obtained by interview, chart review, and psychometric testing, included sociocultural and family environment, seizure and previous treatment history, child behavior, cognitive functioning (IQ), and family stress. Four latent factors tapping these indicators of risk (acculturative risk, seizure severity, behavior problems, family environment) and two measured variables (IQ and life events) were hypothesized. Outcomes were visit adherence (proportion of scheduled appointments kept, plus proportion without unscheduled contacts), medication report (proportion of visits at which parent report of medication agreed with records), and medication levels (proportion of serum anticonvulsant levels within expected range for dosage). Two-step analytic procedure included confirmatory factor analysis to validate the hypothetical structure of the baseline risk indicators, followed by structural equation modeling to examine longitudinal relations between baseline risk and subsequent adherence outcomes.Results: Significant prospective relationships included acculturative risk associated positively with visit adherence and medication levels, behavior problems associated negatively with visit adherence and medication levels, family environment associated negatively with medication report, life events associated positively with medication levels and visit adherence, and cognitive functioning (IQ) associated positively with medication levels. Seizure severity was not associated significantly with any adherence outcome. There also were no significant within-time associations between adherence outcomes.Conclusions: Contrary to clinical expectations, families at higher acculturative risk and with higher life events reported greater adherence. Seizure severity did not influence adherence. The three adherence measures were statistically independent of each other. Key Words: Epilepsy-AdherenceAcculturative risk-Life events-Family environment.Much has been written about the importance of adherence (or compliance) to medical instructions in children and adults with chronic illnesses. Because "compliance" can have negative connotations, many physicians, researchers, and clinicians prefer the term "adherence" to reflect a patient's willingness to follow prescribed medical advice. This article uses "adherence" as an indicator of patient behavior with regard to following medical advice and a physician's instructions.The problem of adherence to medical advice is not selective but rather is pervasive and affects a broad range of illnesses. Researchers have examined numerous factors as causes and correlates of adherence with th...

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“…15 Patients on once-daily trandolapril had significantly better adherence compared to patients on twice-daily captopril treatment for hypertension, as measured using MEMS. 240 Self-report adherence was significantly higher in patients taking sustained-release nicardipine twice daily than conventional nicardipine three times daily. 241 Patients treated with a single combination tablet regimen for hypertension had significantly less cardiovascular events compared to those taking the components individually.…”

Section: Reminder Interventionsmentioning

confidence: 93%

“…There are many reminder interventions that have been implemented, including reminder phone calls, texts, pagers, interactive voice response systems and treatment simplification interventions. 130,220,[236][237][238][239][240][241][242][243] Reminder packaging (dose administration aids, dosette boxes and dose sachets) assembles medicine doses into days and/or times when the medication has to be taken. This has been shown to increase the proportion of doses taken, leading to a significantly reduced diastolic blood pressure and also HbA1c levels.…”

Section: Reminder Interventionsmentioning

confidence: 99%

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Improving medication adherence in patients with chronic disease using a targeted and tailored approach

Nguyen¹

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Improving adherence to medications is an opportunity that can yield great improvements in health outcomes and reducing health costs. Supporting adherence to medicines requires insight into a patient's medication-taking behaviour and their reasons for non-adherence.Adherence interventions that show most promise include multifaceted interventions, and those targeted to non-adherent patients and/or tailored to patient-specific reasons for nonadherence. To identify non-adherent patients and their reasons for non-adherence in the practice setting, I argue that we require inexpensive measures that are easy to use and can inform the discussion with patients about their adherence. Adherence scales are inexpensive, easy-to-administer and have the potential to explore both medication-taking behaviour and reasons for behaviour.The overall aim of the thesis is to determine if a targeted and tailored intervention based on a discussion informed by validated adherence scales, will improve adherence to a recently initiated cardiovascular medication. I hypothesise that targeting and tailoring an intervention to non-adherent participants based on a discussion informed by adherence scales, will improve adherence at three months as measured by the four-item Medication Adherence Questionnaire (MAQ). I will also test whether improvements in adherence at three months are sustained at six months and explore the changes in adherence and reasons for nonadherence over time.The first part of the thesis involved identifying validated adherence scales suitable for use in the intervention. A systematic review was conducted on adherence scales to explore their use and validation. We found that adherence scales measured different aspects of adherence: medication-taking behaviour, barriers to adherence and beliefs associated with adherence. Adherence scales have been validated in different disease populations and against different measures of adherence. We selected two adherence scales for our study: the MAQ and Beliefs about Medicines Questionnaire-Specific (BMQ-S). The MAQ is one of the most commonly used adherence scales that has been validated in many disease populations and against different measures of adherence including electronic monitoring.The BMQ-S has been extensively used to elicit medication beliefs associated with medication adherence and validated in a number of diseases including cardiovascular disease, asthma and depression.A randomised controlled trial was conducted to determine if a targeted and tailored intervention would improve medication adherence. Four hundred and eight patients were iii assessed for eligibility from two community pharmacies, from which 152 patients were enrolled into the study. All enrolled participants completed the MAQ, BMQ-S and Brief Illness Perceptions Questionnaire (BIPQ). There were 120 participants identified as non-adherent using the MAQ, who were randomised into an intervention or control group. The remaining 32 participants were identified as adherent. In the intervention group, the r...

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Electronic pill-boxes in the evaluation of antihypertensive treatment compliance: comparison of once daily versus twice daily regimen

Cited by 76 publications

References 19 publications

The COMpliance PraxiS Survey (COMPASS): a multidimensional instrument to monitor compliance for patients on antihypertensive medication

The COMpliance PraxiS Survey (COMPASS): a multidimensional instrument to monitor compliance for patients on antihypertensive medication

Adherence to Treatment in Children With Epilepsy: Who Follows "Doctor's Orders"?

Improving medication adherence in patients with chronic disease using a targeted and tailored approach

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