P-608: Can drug-compliance and blood pressure control be improved by self-measurement and electronic reminders?

• Published in: American journal of hypertension Vol. 14; no. S1; p. 233A
• Main Authors: Mengden, T., Köhler, C., Uen, S., Weisser, B., Vetter, H., Düsing, R.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.2001
• Subjects: Drug Compliance; Electronic reminders; Self-measurement
• DOI: 10.1016/S0895-7061(01)01915-X
• ISSN: 0895-7061

We have recently reported that electronic drug monitoring allows to identify a patient group with poor compliance between clinic visits (“white-coat compliance”). The purpose of the present study was to investigate the effect of a combined intervention strategy on electronically monitored compliance and ambulatory 24-h-blood pressure measurement (ABPM) in patients with poor compliance. 48 treated patients with essential hypertension with a mean age of 57 years (29-83) were included. Day-to-day drug compliance (correct number and dose interval in %) was monitored with electronic pill boxes (eDEM, Aardex, Switzerland) over a period of 24 weeks. After 6 and 24 weeks weeks ABPM was performed with the Spacelabs 90207 monitor and mean BP values over the whole 24 h period were used for analysis. After 6 weeks patients with poor compliance (<90%) were instructed in self blood pressure measurement (Omron IC system). Furthermore, adherence to daily self-measurement and drug intake was reinforced by accoustic reminders (Omron IC system) and digital displays on the electronic pill boxes. The main results are given in the table (# p<0,001 before vs after intervention) Before intervention After intervention Compliance ABPM (mmHg) Compliance ABPM (mmHg) 97 ±4 % 134 ± 13 / 96 ± 4 % 133 ± 14 (n=23) 81 ± 9 (n.s.) 81 ± 10 (n.s.) 64 ±26 % 131 ± 11 / 86 ± 16 % 132 ± 11 / (n=20) 80 ± 8 (#) 81 ± 8 (n.s.) Determinants of compliance such as age, duration of hypertension and number of antihypertensive drugs were similar in good and poor compliers. Electronically monitored compliance can substantially by improved by self-management techniques and electronic reminders. Due to the effect of “white-coat”-compliance on days of clinic visits this did not affect blood control as assessed by ABPM.