Determinants of dropout rate among hypertensive patients in an urban clinic.
Noncompliance with follow-up is a serious problem in the management of hypertension. A retrospective cohort study examined dropout rates and their determinants among 249 randomly selected outpatients with essential hypertension from the medical clinic of an urban teaching hospital. Data were abstracted from hospital records and a subset of dropouts was interviewed. A lifetable analysis revealed that patients who were initiating therapy or who had been under therapy for less than six months had a 50% chance of remaining in care two years later, while 70% of patients who had been under therapy for more than six months at entry were still in care after this period. Patients who were less severely ill by several indicators were the most likely to drop out. It is hypothesized that the low perceived severity of illness, coupled with the costs and inconvenience of care and the lack of physician enthusiasm for the treatment of mild hypertension leads to non-compliance with follow-up.
D000328:Adult; D005260:Female; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010352:Patient Dropouts; D012189:Retrospective Studies; D014505:Urban Population
Circulation. 1973 Jan;47(1):76-8
4686606
Lancet. 1969 Mar 1;1(7592):457-8
4179514
Pediatrics. 1964 Jul;34:127-32
14181975
J Chronic Dis. 1970 Feb;22(8):579-92
5437451
J Community Health. 1978 Fall;4(1):67-72
690264
J Chronic Dis. 1962 Nov;15:1025-36
13965009
Arch Environ Health. 1966 Jan;12(1):63-9
4951662
N Engl J Med. 1968 Dec 5;279(23):1262-7
5688175
Yale J Biol Med. 1961 Oct;34:117-23
13863833
Lancet. 1975 Dec 20;2(7947):1227-30
53721
Circulation. 1973 Nov;48(5):1104-11
4201656
JAMA. 1973 Apr 23;224(4):481-5
4739606
Minn Med. 1969 Aug;52(8):1303-6
5805000
Nurs Res. 1968 Jan-Feb;17(1):52-5
5183388
Arch Intern Med. 1978 May;138(5):700-3
646534
Circulation. 1973 Jan;47(1):73-5
4405615
JAMA. 1974 Jun 17;228(12 ):1563-7
4406708