title: [Control of therapeutic inertia in the treatment of arterial hypertension by using different strategies].
abstract: OBJECTIVE
  To evaluate the efficacy of different interventions on therapeutic Inertia (TI) in mild-to-moderate hypertension (AHT).
  
  
  METHODS
  Controlled, randomised clinical trial.
  
  
  METHODS
  Two hundred clinics in 5 primary care centres. Spain.
  
  
  METHODS
  A total of 1104 patients with uncontrolled hypertension were included.
  
  
  METHODS
  Four groups with 276 patients were formed: 1) Control group (CG): standard health intervention; 2) Education intervention and a program of home blood pressure monitoring (HBPM) (EG); 3) Card control intervention and HBPM programme (CHG); 4) Education intervention, card control and HBPM programme (ECHG).
  
  
  METHODS
  TI was calculated by the rate: (Number of patients whose pharmacological treatment was not changed in each visit/Number of patients with an average BP 140mmHg and/or 90mmHg in the general population or 130 and/or 90 mmHg in diabetics). The mean BPs and the percentage of controlled patients were calculated. The mean number of people that required an intervention in order to avoid TI was calculated (NI).
  
  
  RESULTS
  A total of 921 patients completed the study, and 1842 visits were made, with TI in 36.8% (IC=5.8%) of the sample and in 82.58% (IC=8.2%) of the uncontrolled hypertensive patients. The TI was 60% (CI=4.2%), 38.4% (CI=4.4%) 30.2 (CI=4.3%) and 14.7 (CI=3.3%) (p=0.001) for CG, EG, CHG and ECHG, respectively. The percentage controlled at the end of study was 35.3% (CI=1.1%), 54.7% (CI=1.8%), 60.2% (CI=2.1%) and 65.1% (CI=2.2%) (p<0.01) for CG, EG, CHG and ECHG, respectively. The NI were 4.6, 3.3 and 2.2 for CG, EG, CHG and ECHG, respectively.
  
  
  CONCLUSIONS
  TI was very significant among the uncontrolled hypertensive patients. The studied interventions are effective for improving TI.
authors.affiliation: Centro de Salud La Orden, Huelva, España. emarquezc@papps.org
authors.forename: Emilio
authors.initials: E
authors.lastname: Márquez Contreras
authors.forename: Nieves
authors.initials: N
authors.lastname: Martel Claros
authors.forename: Vicente
authors.initials: V
authors.lastname: Gil Guillén
authors.forename: José Luis
authors.initials: JL
authors.lastname: Martín De Pablos
authors.forename: Mariano
authors.initials: M
authors.lastname: De La Figuera Von Wichman
authors.forename: José Joaquin
authors.initials: JJ
authors.lastname: Casado Martínez
authors.forename: Jacinto
authors.initials: J
authors.lastname: Espinosa García
mesh_terms: D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged