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

Détails

ID Serval
serval:BIB_B7B9216203EB
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Impact of electronic monitoring of drug adherence on blood pressure control in primary care: a cluster 12-month randomised controlled study.
Périodique
European Journal of Internal Medicine
Auteur(s)
Santschi V., Rodondi N., Bugnon O., Burnier M.
ISSN
0953-6205
Statut éditorial
Publié
Date de publication
2008
Peer-reviewed
Oui
Volume
19
Numéro
6
Pages
427-434
Langue
anglais
Résumé
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.
Mots-clé
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
Création de la notice
25/03/2009 16:04
Dernière modification de la notice
03/03/2018 20:48
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