Efficacy of telephone and mail intervention in patient compliance with antihypertensive drugs in hypertension. ETECUM-HTA study

Author： Contreras Emilio Márquez GarcÍa Onofre Vegazo Claros Nieves Martel Guillén Vicente Gil Wichmann Mariano de la Figuera von Martínez José Joaquín Casado Fernández Raúl

Publisher： Informa Healthcare

ISSN： 0803-7051

Source： Blood Pressure, Vol.14, Iss.3, 2005-07, pp. : 151-158

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Abstract

Objective . To study the efficacy of telephone and mail intervention in therapeutic compliance among patients with mild to moderate hypertension. Design . A prospective controlled multicenter clinical trial. Setting . Eighty-five primary care centers in Spain, with a duration of 6 months. Patients . 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. Main outcome measure . 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.