How to avoid discontinuation of antihypertensive treatment: The experience in São Paulo, Brazil.
OBJECTIVE
To evaluate the importance of providing guidelines to patients via active telephone calls for blood pressure control and for preventing the discontinuation of treatment among hypertensive patients.


BACKGROUND
Many reasons exist for non-adherence to medical regimens, and one of the strategies employed to improve treatment compliance is the use of active telephone calls.


METHODS
Hypertensive patients (n=354) who could receive telephone calls to remind them of their medical appointments and receive instruction about hypertension were distributed into two groups: a) "uncomplicated" - hypertensive patients with no other concurrent diseases and b) "complicated" - severe hypertensive patients (mean diastolic ≥ 110 mmHg with or without medication) or patients with comorbidities. All patients, except those excluded (n=44), were open-block randomized to follow two treatment regimens ("traditional" or "current") and to receive or not receive telephone calls ("phone calls" and "no phone calls" groups, respectively).


RESULTS
Significantly fewer patients in the "phone calls" group discontinued treatment compared to those in the "no phone calls" group (4 vs. 30; p<0.0094). There was no difference in the percentage of patients with controlled blood pressure in the "phone calls" group and "no phone calls" group or in the "traditional" and "current" groups. The percentage of patients with controlled blood pressure (<140/90 mmHg) was increased at the end of the treatment (74%), reaching 80% in the "uncomplicated" group and 67% in the "complicated" group (p<0.000001).


CONCLUSIONS
Guidance to patients via active telephone calls is an efficient strategy for preventing the discontinuation of antihypertensive treatment.
Hospital das Clínicas, Universidade de São Paulo, SP, Brazil. katiaortega29@gmail.com
Katia Coelho
KC
Ortega
Josiane Lima de
JL
Gusmão
Angela Maria Geraldo
AM
Pierin
José Luiz
JL
Nishiura
Edna Caetano
EC
Ignez
Carlos Alexandre
CA
Segre
Carlucci Gualberto
CG
Ventura
Gisele Peixoto
GP
Mano
Viviane
V
Fontes
Francisco Mogadouro da
FM
Cunha
Décio
D
Mion
D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy*; D019808:Losartan / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D013689:Telephone; D016903:Drug Monitoring
D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D006852:Hydrochlorothiazide; D001262:Atenolol; D019808:Losartan