Márquez Contreras Emilio, Martel Claros Nieves, Gil Guillén Vicente, Martín De Pablos José Luis, De la Figuera Von Wichman Mariano, Casado Martínez José Joaquín, Espinosa García Jacinto, Pastoriza Vilas José Carlos
Centro de Salud la Orden, Huelva, España.
Unidad de Hipertensión, Hospital Clínico San Carlos, Madrid, España.
Aten Primaria. 2009 Sep;41(9):501-510. doi: 10.1016/j.aprim.2009.02.004. Epub 2009 Jun 3.
To evaluate the efficacy of an intervention by means of an educational magazine on treatment compliance in uncontrolled arterial hypertension (AHT).
Controlled, randomised clinical trial.
87 primary care centres. Spain.
A total of 450 patients with uncontrolled hypertension were included.
Two groups of 225 patients were formed: 1) Control group (CG): standard health intervention; 2) Intervention Group (IG): received a twice monthly educational magazine at home.
Compliance was measured using the Medication Event Monitoring System (MEMS-Aardex). Compliance rate (CR) was recorded. Compliers were defined as individuals with a treatment compliance of 80-110%. The percentage of compliers, the mean percentage of doses taken and the percentage of patients taking the medication at the correct times were estimated. The mean blood pressures (BPs) and the percentage of controlled patientswere calculated. The number needed to treat (NNT) was calculated.
A total of 393 individuals were evaluable (Age: 62.4 years), 196 in the IG and 197 in the CG. There were 83.2% (95% CI 78-88.4) and 49.2% (95% CI 42.2-56.2) (P=0.0001) of overall compliers in the IG and CG, respectively and 74% (95% CI: 67.9-80.1) and 42.6% (95% CI=35.7-49.5) (P=0.0001) of correct times compliers. A total of 81.6% (95% CI=76.2-86.5%)) were controlled in the IG and 56.3% (95% CI=49.4-63.2) in the CG. The NNT was 3.3 patients.
Therapeutic non-compliance was very high. The educational magazine is an effective strategy to improve the compliance and degree of control of the AHT.
通过一本教育杂志评估一项干预措施对未控制的动脉高血压（AHT）患者治疗依从性的疗效。
对照随机临床试验。
西班牙87个初级保健中心。
共纳入450例未控制高血压患者。
将患者分为两组，每组225例：1）对照组（CG）：标准健康干预；2）干预组（IG）：在家中每月收到两期教育杂志。
使用药物事件监测系统（MEMS - Aardex）测量依从性。记录依从率（CR）。依从者定义为治疗依从性在80% - 110%之间的个体。估计依从者的百分比、服用剂量的平均百分比以及在正确时间服药的患者百分比。计算平均血压（BP）和血压得到控制的患者百分比。计算治疗所需人数（NNT）。
共有393人可进行评估（年龄：62.4岁），其中干预组196人，对照组197人。干预组和对照组的总体依从者分别为83.2%（95%置信区间78 - 88.4）和49.2%（95%置信区间42.2 - 56.2）（P = 0.0001），在正确时间服药的依从者分别为74%（95%置信区间：67.9 - 80.1）和42.6%（95%置信区间 = 35.7 - 49.5）（P = 0.0001）。干预组共有81.6%（95%置信区间 = 76.2 - 86.5%）的患者血压得到控制，对照组为56.3%（95%置信区间 = 49.4 - 63.2）。治疗所需人数为3.3例患者。
治疗不依从情况非常严重。教育杂志是提高AHT患者依从性和控制程度的有效策略。
