How to avoid discontinuation of antihypertensive treatment. The experience in São Paulo, Brazil
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 improv...
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| Published in | Clinics (São Paulo, Brazil) Vol. 65; no. 9; pp. 857 - 863 |
|---|---|
| Main Authors | , , , , , , , , , , |
| 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 |
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| Abstract | 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. |
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| AbstractList | 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. OBJECTIVESTo 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. INTRODUCTIONMany 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. METHODSHypertensive 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). RESULTSSignificantly 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). CONCLUSIONGuidance to patients via active telephone calls is an efficient strategy for preventing the discontinuation of antihypertensive treatment. 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. OBJECTIVES: 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. INTRODUCTION: 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). CONCLUSION: Guidance to patients via active telephone calls is an efficient strategy for preventing the discontinuation of antihypertensive treatment. |
| Author | de Gusmão, Josiane Lima Ventura, Carlucci Gualberto da Cunha, Francisco Mogadouro Ignez, Edna Caetano Mion, Décio Nishiura, José Luiz Pierin, Angela Maria Geraldo Fontes, Viviane Mano, Gisele Peixoto Ortega, Katia Coelho Segre, Carlos Alexandre |
| AuthorAffiliation | Universidade Guarulhos Universidade de São Paulo |
| AuthorAffiliation_xml | – name: Universidade de São Paulo – name: Universidade Guarulhos |
| Author_xml | – sequence: 1 givenname: Katia Coelho surname: Ortega fullname: Ortega, Katia Coelho email: katiaortega29@gmail.com organization: Hypertension Unit, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil – sequence: 2 givenname: Josiane Lima surname: de Gusmão fullname: de Gusmão, Josiane Lima organization: Hypertension Unit, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil – sequence: 3 givenname: Angela Maria Geraldo surname: Pierin fullname: Pierin, Angela Maria Geraldo organization: Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil – sequence: 4 givenname: José Luiz surname: Nishiura fullname: Nishiura, José Luiz organization: Hypertension Unit, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil – sequence: 5 givenname: Edna Caetano surname: Ignez fullname: Ignez, Edna Caetano organization: Hypertension Unit, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil – sequence: 6 givenname: Carlos Alexandre surname: Segre fullname: Segre, Carlos Alexandre organization: Hypertension Unit, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil – sequence: 7 givenname: Carlucci Gualberto surname: Ventura fullname: Ventura, Carlucci Gualberto organization: Hypertension Unit, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil – sequence: 8 givenname: Gisele Peixoto surname: Mano fullname: Mano, Gisele Peixoto organization: Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil – sequence: 9 givenname: Viviane surname: Fontes fullname: Fontes, Viviane organization: Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil – sequence: 10 givenname: Francisco Mogadouro surname: da Cunha fullname: da Cunha, Francisco Mogadouro organization: Hypertension Unit, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil – sequence: 11 givenname: Décio surname: Mion fullname: Mion, Décio organization: Hypertension Unit, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil |
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| Keywords | Hypertension Patient Adherence Antihypertensive Drugs Therapeutics Medication Compliance |
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Flegal, K; Furie, K; Go, A; Greenlund, K; Haase, N – volume: 89 start-page: e24 year: 2007 end-page: 79 article-title: V Brazilian Guidelines in Arterial Hypertension publication-title: Arq Bras Cardiol. – volume: 64 start-page: 619 year: 2009 end-page: 28 article-title: Health-related quality of life and blood pressure control in hypertensive patients with and without complications publication-title: Clinics contributor: fullname: Gusmão JL, de; Mion Jr., D; Pierin, AMG. – volume: 366 start-page: 907 year: 2005 end-page: 13 article-title: Role of blood pressure and other variables in the differential cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA) publication-title: Lancet. contributor: fullname: Poulter, NR; Wedel, H; Dahlöf, B; Sever, PS; Beevers, DG; Caulfield, M – volume: 353 start-page: 487 year: 2005 end-page: 97 article-title: Drug therapy: adherence to medication publication-title: NEJM. contributor: fullname: Osterberg, L; Blaschke, T – volume: 10 start-page: 697 year: 1997 end-page: 704 article-title: The effects of initial drug choice and comorbidity on antihypertensive therapy compliance: results from a population-based study in the elderly publication-title: Am J Hypertens. contributor: fullname: Monane, M; Bohn, RL; Gurwitz, JH; Glynn, RJ; Levin, R; Avorn, J. – volume: 13 start-page: 137 year: 2004 end-page: 41 article-title: Cardiovascular events in elderly patients with isolated systolic hypertension: A subgroup analysis of treatment strategies in STOP-Hypertension-2 publication-title: Blood Press. contributor: fullname: Ekbom, T; Linjer, E; Hedner, T; Lanke, J; de Faire, U; Wester, P-O – volume: 14 start-page: 151 year: 2005 end-page: 8 article-title: Efficacy of telephone and mail intervention in patient compliance with antihypertensive drugs in hypertension: ETECUM-HTA study publication-title: Blood Press contributor: fullname: Márquez, CE; Vegazo, GO; Claros, NM; Gil, GV; de la Figuera von Wichmann, M |
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| Snippet | To evaluate the importance of providing guidelines to patients via active telephone calls for blood pressure control and for preventing the discontinuation of... OBJECTIVESTo evaluate the importance of providing guidelines to patients via active telephone calls for blood pressure control and for preventing the... OBJECTIVES: To evaluate the importance of providing guidelines to patients via active telephone calls for blood pressure control and for preventing the... |
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| SubjectTerms | 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 |
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| Title | How to avoid discontinuation of antihypertensive treatment. The experience in São Paulo, Brazil |
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