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

• Published in: Blood pressure 2005-07, Vol.14 (3), p.151-158
• Main Authors: Contreras, Emilio Márquez, GarcÍa, Onofre Vegazo, Claros, Nieves Martel, Guillén, Vicente Gil, Wichmann, Mariano de la Figuera von, Martínez, José Joaquín Casado, Fernández, Raúl
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antihypertensive Agents - therapeutic use; Compliance; Female; Humans; hypertension; Hypertension - diagnosis; Hypertension - drug therapy; mail intervention; Male; Middle Aged; Outpatients - statistics & numerical data; Patient Compliance - statistics & numerical data; Postal Service; Prospective Studies; Spain; telemedicine; Telephone; telephone intervention
• ISSN: 0803-7051; 1651-1999
• DOI: 10.1080/08037050510008977

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