Impact of electronic monitoring of drug adherence on blood pressure control in primary care: a cluster 12-month randomised controlled study.

Details

Serval ID
serval:BIB_B7B9216203EB
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of electronic monitoring of drug adherence on blood pressure control in primary care: a cluster 12-month randomised controlled study.
Journal
European Journal of Internal Medicine
Author(s)
Santschi V., Rodondi N., Bugnon O., Burnier M.
ISSN
0953-6205
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
19
Number
6
Pages
427-434
Language
english
Abstract
BACKGROUND: Poor long-term adherence is an important cause of uncontrolled hypertension. We examined whether monitoring drug adherence with an electronic system improves long-term blood pressure (BP) control in hypertensive patients followed by general practitioners (GPs). METHODS: A pragmatic cluster randomised controlled study was conducted over one year in community pharmacists/GPs' networks randomly assigned either to usual care (UC) where drugs were dispensed as usual, or to intervention (INT) group where drug adherence could be monitored with an electronic system (Medication Event Monitoring System). No therapy change was allowed during the first 2 months in both groups. Thereafter, GPs could modify therapy and use electronic monitors freely in the INT group. The primary outcome was a target office BP<140/90 mmHg. RESULTS: Sixty-eight treated uncontrolled hypertensive patients (UC: 34; INT: 34) were enrolled. Over the 12-month period, the likelihood of reaching the target BP was higher in the INT group compared to the UC group (p<0.05). At 4 months, 38% in the INT group reached the target BP vs. 12% in the UC group (p<0.05), and 21% vs. 9% at 12 months (p: ns). Multivariate analyses, taking account of baseline characteristics, therapy modification during follow-up, and clustering effects by network, indicate that being allocated to the INT group was associated with a greater odds of reaching the target BP at 4 months (p<0.01) and at 12 months (p=0.051). CONCLUSION: GPs monitoring drug adherence in collaboration with pharmacists achieved a better BP control in hypertensive patients, although the impact of monitoring decreased with time.
Keywords
Adult, Aged, Aged, 80 and over, Antihypertensive Agents, Blood Pressure Monitoring, Ambulatory, Electronics, Medical, Female, Humans, Hypertension, Male, Medication Adherence, Middle Aged, Treatment Outcome
Pubmed
Web of science
Create date
25/03/2009 15:04
Last modification date
20/08/2019 15:25
Usage data