title: Efficacy of a brief multifactorial adherence-based intervention on reducing the blood pressure of patients with poor adherence: protocol for a randomized clinical trial.
abstract: BACKGROUND
  Lowering of blood pressure by antihypertensive drugs reduces the risks of cardiovascular events, stroke, and total mortality. However, poor adherence to antihypertensive medications reduces their effectiveness and increases the risk of adverse events. In terms of relative risk reduction, an improvement in medication adherence could be as effective as the development of a new drug.
  
  
  METHODS
  The proposed randomized controlled trial will include patients with a low adherence to medication and uncontrolled blood pressure. The intervention group will receive a multifactorial intervention during the first, third, and ninth months, to improve adherence. This intervention will include motivational interviews, pill reminders, family support, blood pressure self-recording, and simplification of the dosing regimen.
  
  
  METHODS
  The primary outcome is systolic blood pressure. The secondary outcomes are diastolic blood pressure, proportion of patients with adequately controlled blood pressure, and total cost.
  
  
  CONCLUSIONS
  The trial will evaluate the impact of a multifactorial adherence intervention in routine clinical practice. Ethical approval was given by the Ethical Committee on Human Research of Balearic islands, Spain (approval number IB 969/08 PI).
authors.affiliation: Primary Care Research Unit of Mallorca, Baleares Health services-IbSalut, CAIBER, Mallorca, Spain. aleiva@ibsalut.caib.es
authors.forename: Alfonso
authors.initials: A
authors.lastname: Leiva
authors.forename: Marta
authors.initials: M
authors.lastname: Fajó
authors.forename: Luís
authors.initials: L
authors.lastname: Escriche
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Audera
authors.forename: Sara
authors.initials: S
authors.lastname: López
authors.forename: Ma Carmén
authors.initials: MC
authors.lastname: Martín
authors.forename: Rosa
authors.initials: R
authors.lastname: González
authors.forename: Gaspar
authors.initials: G
authors.lastname: Tamborero
authors.forename: Elena M
authors.initials: EM
authors.lastname: García
authors.forename: Rosa
authors.initials: R
authors.lastname: Duro
authors.forename: Ramón
authors.initials: R
authors.lastname: Orueta
authors.forename: Francisca
authors.initials: F
authors.lastname: Serra
authors.forename: Pilar
authors.initials: P
authors.lastname: D'agosto P
authors.forename: Jerónima
authors.initials: J
authors.lastname: Miralles
authors.forename: Patricia
authors.initials: P
authors.lastname: Lorente
authors.forename: Joan
authors.initials: J
authors.lastname: Llobera
authors.forename: Ana Aurelia
authors.initials: AA
authors.lastname: Iglesias
authors.forename: Ruth
authors.initials: R
authors.lastname: Fernández
authors.forename: María M
authors.initials: MM
authors.lastname: Colom
authors.forename: Aina M
authors.initials: AM
authors.lastname: Buades
authors.forename: Lucía
authors.initials: L
authors.lastname: Moreno
authors.forename: Clara
authors.initials: C
authors.lastname: Vidal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use*; D001795:Blood Pressure Determination; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000191:economics / Q000503:physiopathology / Q000523:psychology; D007406:Interview, Psychological; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D009042:Motivation; D012107:Research Design; D012306:Risk; D020521:Stroke / Q000517:prevention & control; D016896:Treatment Outcome; D016903:Drug Monitoring
chemical_list: D000959:Antihypertensive Agents