Efficacy of telephone and mail intervention in patient compliance with antihypertensive drugs in hypertension. ETECUM-HTA study.
OBJECTIVE
To study the efficacy of telephone and mail intervention in therapeutic compliance among patients with mild to moderate hypertension.


METHODS
A prospective controlled multicenter clinical trial.


METHODS
Eighty-five primary care centers in Spain, with a duration of 6 months.


METHODS
A total of 636 patients with newly diagnosed or uncontrolled hypertension were included. Interventions. The patients were randomized and distributed between the following groups: (i) control (CG) - under routine clinical management; (ii) mail intervention (MIG) - received a mailed message reinforcing compliance and reminding of the visits (15 days, 2 and 4 months); (iii) telephone intervention (TIG) - received a telephone call at 15 days, then at 7 and 15 weeks.


METHODS
Five visits were scheduled, with the measurement of blood pressure and counting of tablets. Compliers were defined as subjects showing 80-110% drug consumption. Calculations were made of mean percentage compliance (MPC) and compliers, mean blood pressure and percentage controlled subjects.


RESULTS
Five hundred and thirty-eight patients completed the study (261 males); 85.5% were compliers (CI = 82.5-88.5; n = 460). The MPC was 95.1+/-19.6% (CI = 93.28-96.92). The CG consisted of 182 individuals, MIG = 172 and TIG = 184. Compliers represented 69.2% of the CG (CI 62.5-75.9%), 91.3% (CI = 87.1-95.5) of the MIG (p = 0.0001) and 96.2% of the TIG (CI 93.5-98.9%); the final MPC was 89.6%+/-15 in CG, 96.6%+/-12 in MIG and 99.1+/-26.8 in TIG (p = 0.0001). The percentage of controlled subjects was 47.2% in CG (CI = 40-54.4), 61.3% in MIG (CI = 54.1-68.5%) and 63.3% in TIG (CI = 56.4-70.2%) (p<0.05).


CONCLUSIONS
TIG and MIG are effective measures for improving patient compliance in hypertension.
Márquez Contreras
Emilio
E
Centro de Salud la Orden, Huelva, Spain. emarquezc@papps.org
Vegazo García
Onofre
O
Martel Claros
Nieves
N
Gil Guillén
Vicente
V
de la Figuera von Wichmann
Mariano
M
Casado Martínez
José Joaquín
JJ
Fernández
Raúl
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011177:Postal Service; D011446:Prospective Studies; D013030:Spain; D013689:Telephone
D000959:Antihypertensive Agents