Electronic compliance monitoring in resistant hypertension: the basis for rational therapeutic decisions.

Details

Serval ID
serval:BIB_05568F8E8662
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Electronic compliance monitoring in resistant hypertension: the basis for rational therapeutic decisions.
Journal
Journal of hypertension
Author(s)
Burnier M., Schneider M.P., Chioléro A., Stubi C.L., Brunner H.R.
ISSN
0263-6352
Publication state
Published
Issued date
2001
Peer-reviewed
Oui
Volume
19
Number
2
Pages
335-41
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Abstract
OBJECTIVE: Incomplete compliance is one of several possible causes of uncontrolled hypertension. Yet, non-compliance remains largely unrecognized and is falsely interpreted as treatment resistance, because it is difficult to confirm or exclude objectively. The goal of this study was to evaluate the potential benefits of electronic monitoring of drug compliance in the management of patients with resistant hypertension. METHODS: Forty-one hypertensive patients resistant to a three-drug regimen (average blood pressure 156/ 106 +/- 23/11 mmHg, mean +/- SD) were studied prospectively. They were informed that for the next 2 months, their presently prescribed drugs would be provided in electronic monitors, without any change in treatment, so as to provide the treating physician with a measure of their compliance. Thereafter, patients were offered the possibility of prolonging the monitoring of compliance for another 2 month period, during which treatment was adapted if necessary. RESULTS: Monitoring of compliance alone was associated with a significant improvement of blood pressure at 2 months (145/97 +/- 20/15 mmHg, P < 0.01). During monitoring, blood pressure was normalized (systolic < 140 mmHg or diastolic < 90 mmHg) in one-third of the patients and insufficient compliance was unmasked in another 20%. When analysed according to tertiles of compliance, patients with the lowest compliance exhibited significantly higher achieved diastolic blood pressures (P = 0.04). In 30 patients, compliance was monitored up to 4 months and drug therapy was adapted whenever necessary. In these patients, a further significant decrease in blood pressure was obtained (from 150/100 +/- 18/15 to 143/94 +/- 22/11 mmHg, P = 0.04/0.02). CONCLUSIONS: These results suggest that objective monitoring of compliance using electronic devices may be a useful step in the management of patients with refractory hypertension, as it enables physicians to take rational decisions based on reliable and objective data of drug compliance and hence to improve blood pressure control.
Keywords
Adult, Aged, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Hypertension, Male, Middle Aged, Patient Compliance, Prospective Studies
Pubmed
Web of science
Create date
25/01/2008 12:55
Last modification date
20/08/2019 12:27
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