Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: a prospective case-control study

Abstract

Objectives To prospectively compare compliance with treatment in patients with hypertension responsive to treatment versus patients with treatment resistant hypertension. Design Prospective case-control study. Setting Outpatient department in a large city hospital in Switzerland, providing primary, secondary, and tertiary care. Participants 110 consecutive medical outpatients with hypertension and taking stable treatment with at least two antihypertensive drugs for at least four weeks. Main outcome measures Treatment compliance assessed with MEMS devices; blood pressure determined by 12 hour daytime ambulatory monitoring (pressure < 135/85 mm Hg in patients aged <60 years and < 155/90 mm Hg in patients aged > 60 indicated hypertension responsive to treatment). Results Complete data were available for 103 patients, of whom 86 took >80% of their prescribed doses ("compliant") and 17 took < 80% ("non-compliant"). Of the 49 patients with treatment resistant hypertension, 40 (82%) were compliant, while 46 (85%) of the 54 patients responsive to treatment were compliant. Conclusion Non-compliance with treatment was not more prevalent in patients with treatment resistant hypertension than in treatment responsive patients.

Influencia de factores psicosociales en la adherencia al tratamiento farmacológico antihipertensivo: Resultados de una cohorte del Programa de Salud Cardiovascular de la Región Metropolitana, Chile

“…Sin embargo, en nuestro estudio la adherencia al tratamiento farmacológico prescrito no pareció ser un factor claramente relacionado con el control de la PA, aunque en los adherentes hubo una reducción ligeramente mayor pero no significativa de la PA. Esta discordancia entre la adherencia y PA obtenida a través del tratamiento farmacológico ha sido descrita por otros 29 , incluso en estudios en que la apertura de los envases de los medicamentos prescritos fue monitorizada por mecanismos electrónicos [30][31][32][33][34][35] . Es, por lo tanto, aparente la existencia de otros factores en juego para lograr un adecuado control de la PA, los que actuarían por mecanismos no bien esclarecidos como hemos sugerido en publicaciones previas de esta cohorte (relación médico paciente, estrés emocional y depresión, nivel educacional) 10 .…”

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

“…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.…”

Relationship between medication adherence and blood pressure in primary care: prospective study

“…2 Previous studies in this field used either arbitrary categorical cut points or unreliable measures of adherence. [2][3][4] In this study, we aimed to investigate prospectively the relationship between medication adherence and blood pressure as continuous variables in people with uncontrolled hypertension.…”