How to avoid discontinuation of antihypertensive treatment. The experience in São Paulo, Brazil

• Published in: Clinics (São Paulo, Brazil) Vol. 65; no. 9; pp. 857 - 863
• Main Authors: Ortega, Katia Coelho, de Gusmão, Josiane Lima, Pierin, Angela Maria Geraldo, Nishiura, José Luiz, Ignez, Edna Caetano, Segre, Carlos Alexandre, Ventura, Carlucci Gualberto, Mano, Gisele Peixoto, Fontes, Viviane, da Cunha, Francisco Mogadouro, Mion, Décio
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Elsevier España, S.L.U 2010; Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo; Faculdade de Medicina / USP; Elsevier España
• Subjects: Angiotensin II Type 1 Receptor Blockers - therapeutic use; Antihypertensive Agents - therapeutic use; Antihypertensive Drugs; Atenolol - therapeutic use; Calcium Channel Blockers - therapeutic use; Clinical Protocols; Clinical Science; Female; Humans; Hydrochlorothiazide - therapeutic use; Hypertension; Hypertension - drug therapy; Losartan - therapeutic use; Male; Medication Adherence - statistics & numerical data; Medication Compliance; MEDICINE, GENERAL & INTERNAL; Middle Aged; Patient Adherence; Telephone; Therapeutics; Hypertension; Patient Adherence; Antihypertensive Drugs; Therapeutics; Medication Compliance
• ISSN: 1807-5932; 1980-5322; 1980-5322
• DOI: 10.1590/S1807-59322010000900008

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. 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. 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). 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). Guidance to patients via active telephone calls is an efficient strategy for preventing the discontinuation of antihypertensive treatment.