[Behavior of patients with mild-to-moderate arterial hypertension in relation to their treatment. Contribution of an electronic pillbox].
The objective of the MACH1 study (MEMS for the Assessment of Compliance of Hypertensives) was to evaluate the real behaviour of patients in relation to antihypertensive treatment administered as a single daily dose. After a 2-week period during which no other antihypertensive was allowed to be administered, 590 patients with mild-to-moderate hypertension received 2 mg of trandolapril as a single daily dose in the morning between 7:00 a.m. and 9:00 a.m. for 4 weeks. Treatment was packaged in electronic pillboxes recording the date and time of each opening. Various profiles were distinguished on the basis of the individual chronograms for the 501 patients able to be analysed in terms of compliance, and as a function of the deviations observed in relation to the treatment regimen prescribed. One hundred and two patients (20%) omitted more than 20% of the prescribed doses, either consecutive doses or scattered throughout the month of treatment; these patients were referred to as "omitters". The other patients were classified according to the scatter of openings in relation to the mean time of the dose: 10 "metronome" patients (2%), 126 "regular" patients (25%), 221 "irregular" patients (44%) and 42 "anarchic" patients (8%). Irregularities of dose times were more frequent on public holidays than on week days and in patients living in Paris or the Paris region. "Metronome" patients were older than the overall patient population. The use of an electronic pillbox could allow the attending physician to more adequately adapt his therapeutic approach and management of specific problems of compliance observed in hypertensive patients.
Mallion
J M
JM
Service de Médecine Interne et Cardiologie, CHU La Tronche, Grenoble.
Dutrey-Dupagne
C
C
Vaur
L
L
Genes
N
N
Renault
M
M
Baguet
P
P
Boutelant
S
S
Elkik
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D003299:Cooperative Behavior; D004305:Dose-Response Relationship, Drug; D005260:Female; D005602:France; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000523:psychology*; D007211:Indoles / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008509:Medication Systems; D008875:Middle Aged; D010349:Patient Compliance
D000806:Angiotensin-Converting Enzyme Inhibitors; D007211:Indoles; C052035:trandolapril
Comportement des patients ayant une hypertension artérielle légère à modérée vis-à-vis de leur traitement. Apport du pilulier électronique.