[The validity of 6 indirect methods for assessing drug treatment compliance in arterial hypertension].

OBJECTIVE

To validate six indirect methods, which were simple and easy to apply in clinical practice, of identifying patients who did not comply with drugs treatment for hypertension.

DESIGN

A prospective study based on two visits to patient's home.

SETTING

rural health centre at Calpe, Alicante.

PATIENTS

174 patients (58 men and 116 women) were included. They were chosen at random from the centre's records of hypertense patients.

MEASUREMENTS AND MAIN RESULTS

Compliance was assessed by the method of a surprise counting of pills in the patient's home. Patients who had between 80 and 110% compliance were defined as compliant. The six indirect methods validated were: communication of self-compliance (CS), attendance at appointments (AA), doctor's judgment (DJ), information about the illness (II), hypertension control (HC) and the Morisky-Green test (MG). II was the most sensitive (81.9%). CS reached the highest specificity (93.4%), the best positive predictive value (81.8%) and the best concordance index (kappa, 0.26).

CONCLUSIONS

II and CS are the indirect methods with the best validity indicators and could be used together to assess compliance with drugs treatment for hypertension.