[Compliance with hypertension therapy in Spain, according to the views of family doctors. Complex project].
OBJECTIVE
To evaluate physicians' knowledge of therapy compliance, their attitudes towards it and their training needs in this field.


METHODS
Transversal, descriptive study using a questionnaire.


METHODS
Primary care centres in Spain.


METHODS
Three thousand and thirty-four general practitioners.


METHODS
Definition of non-compliance, non-compliance in their own consultations and in the rest of Spain, methods of measurement, causes, association with therapy failure, efficacy and use of compliance-enhancing strategies, and need for training.


RESULTS
Most participants (92%; 95% CI, 91.1-92.9) defined non-compliance as patients' failure to take 5%-20% of their pills. A total of 32.4% (95% CI, 30.9%-33.9%) of the physicians estimated that less than 10% of their patients were non-compliers, whereas 6.8% (95% CI, 6.0-7.6) thought this was also the rate in the rest of Spain. The preferred methods of measurement were patient response (77.0%; 75.7-78.4) and their own clinical experience (76.0%; 74.6-77.4). About half (50.7%) believed that lack of compliance was associated with therapy failure in more than 50% of cases. The presence of adverse side-effects was considered a very important cause of poor compliance by 81.9%. The most common and effective strategies were: use of single-dose drugs (84.3%; 83.1-85.5) and nursing support (84.9%; 83.8-86.0). Moreover, 65.2% (63.7-66.7) of the surveyed physicians had not received any education about compliance as medical students and 42% (40.4-43.6) said further training in compliance was needed.


CONCLUSIONS
A high percentage of physicians define compliance incorrectly and believe that other doctors have more non-complying patients than they do. They tend to favour non-validated measuring methods and they lack training.
Márquez Contreras
Emilio
E
Centro de Salud La Orden, Puerto 7, D 21003 Huelva, Spain. emarquezc@papps.org
de la Figuera von Wichmann
Mariano
M
Roig Ponsa
Laura
L
Naval Chamosa
Jordi
J
D000328:Adult; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D018592:Cross-Over Studies; D003625:Data Collection; D003627:Data Interpretation, Statistical; D005194:Family Practice; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D011320:Primary Health Care; D013030:Spain; D011795:Surveys and Questionnaires
Blood Press. 2005;14(3):151-8
16036495
Ann Intern Med. 2001 Nov 6;135(9):825-34
11694107
Aten Primaria. 2001 Sep 30;28(5):305-10
11602099
Med Clin (Barc). 2004 Feb 14;122(5):165-71
14998450
Arch Intern Med. 2004 Apr 12;164(7):722-32
15078641
Aten Primaria. 2004 Nov 15;34(8):399-405
15546536
Am J Hypertens. 1996 Apr;9(4 Pt 1):285-92
8722429
Aten Primaria. 2005 Jan;35(1):7-12
15691448
Eur Heart J. 2005 Aug;26(16):1653-9
15827061
J Hypertens. 2000 Sep;18(9):1348-9
10994769
Aten Primaria. 2000 Jun 15;26(1):5-10
10916893
Aten Primaria. 2006 Oct 15;38(6):325-32
17173796
Med Clin (Barc). 2007 Jan 27;128(3):86-91
17288921
Am J Med. 2004 Nov 15;117(10):747-54
15541324
J Hypertens. 2006 Jan;24(1):169-75
16331115