Efficacy of a home blood pressure monitoring programme on therapeutic compliance in hypertension: the EAPACUM–HTA study

Márquez-Contreras, Emilio; Claros, Nieves Martell; Gil-Guillén, Vicente; Wichmann, Mariano De La Figuera-Von; Casado-Martínez, José Joaquín; Pablos, José Luis Martín-de; Figueras, M.; Galera, J; Serra, Alicia

doi:10.1097/01.hjh.0000198023.53859.a2

Cited by 142 publications

(105 citation statements)

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“…Some studies have reported that home BP measurements might improve patients' drug compliance and increase physicians' concern about their patients' BP control by improving patients' compliance with hypertensive management and by increasing the availability of information on patients' BP. 28,29 Halme et al 30 found that intermittent self-measurement of BP improved BP control compared to ordinary treatment in a multicenter, randomized, parallel-group study in a primary health-care setting. Therefore, it appears that home BP measurements improve the management of hypertension.…”

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confidence: 99%

Home blood pressure measurements associated with better blood pressure control: the J-HOME study

et al. 2008

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The usefulness of self-measurements of blood pressure (BP) at home (home BP measurements) in hypertensive patients has been reported by many studies. Several national guidelines recommend the use of home BP measurements to achieve better hypertension control. The objective of this study was to clarify the association between home BP measurements and hypertension treatment among 2363 essential hypertensive patients taking antihypertensive drugs. Compared to the 543 (23.0%) patients who had not taken home BP measurements, the 1820 (77.0%) patients who had taken home BP measurements were significantly older, included a higher proportion of males, included a higher proportion with a family history of hypertension, took a greater number of antihypertensive drugs and alpha blockers and took antihypertensive drugs more often in the evening. Home BP measurements were associated with significantly better control of home and office BP levels. Compared to patients who had not taken home BP measurements, the adjusted odds ratios for good control of morning home BPs, evening home BPs and office BPs in patients who had taken home BP measurements were 1.46 (95% confidential interval (CI) 1.33-1.57), 1.35 (95% CI 1.21-1.47) and 1.23 (95% CI 1.06-1.37), respectively. Home BP measurements were associated with good hypertensive management. Our findings suggest that it is important that physicians recommend home BP measurements to their patients.

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confidence: 99%

Home blood pressure measurements associated with better blood pressure control: the J-HOME study

et al. 2008

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“…Drug compliance is essential in pharmaceutical care. As previous studies have reported that home BP measurements are associated with good medication compliance 38,39 and the present population measured home BP, patients' compliance might be better in the present population compared with that in other populations.…”

Section: Discussionmentioning

confidence: 43%

Uncontrolled hypertension based on morning and evening home blood pressure measurements from the J-HOME study

et al. 2009

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Imai, the J-HOME Study Group 7We evaluated the control condition of morning and evening home blood pressure (BP) and compared patients who had isolated uncontrolled morning hypertension and those who had sustained uncontrolled (morning and evening) hypertension using data from the Japan Home versus Office Blood Pressure Measurement Evaluation study. We evaluated 3303 treated hypertensive patients (mean age, 66.2 ± 10.5 years; men, 44.7%) in Japan. We classified patients into controlled hypertension, isolated uncontrolled evening hypertension, isolated uncontrolled morning hypertension and sustained uncontrolled hypertension, based on the cutoff value of 135/85 mm Hg for both morning and evening home BP. Of the 3303 patients evaluated, 24.6% had isolated uncontrolled morning hypertension, and 42.0% had sustained uncontrolled hypertension. Factors associated with isolated uncontrolled morning hypertension included taking evening BP measurement after drinking alcohol or bathing. Factors associated with sustained uncontrolled hypertension were male gender, diabetes mellitus and renal disease. The regimen of antihypertensive medication was more complex in patients with uncontrolled morning hypertension than in controlled hypertension. Determinants of the difference between patients with isolated uncontrolled morning hypertension and those with sustained uncontrolled hypertension were diabetes mellitus, renal disease and lower prevalence in measuring evening BP after drinking alcohol or bathing. More than a half of the treated patients were classified into uncontrolled morning hypertension, which were associated with poorer prognosis. Classification of morning hypertensive patients into groups with or without evening hypertension may be useful for evaluating patients' total cardiovascular disease risk. Physicians should also consider evening BP measuring condition for adequate evaluation of evening BP values.

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“…Of eleven randomized controlled trials, six (54%) reported a significant improvement in compliance attributable to self-measurement of blood pressure. 40 In this way, control of blood pressure was higher, 41 and the patients were more satisfied by this approach, which did not increase the cost of treatment. 42 The success of such an approach is even greater if self-monitoring, Internet support, and pharmacy management are used together.…”

Section: The Therapeutic Environmentmentioning

confidence: 91%

Practical issues in medication compliance in hypertensive patients

Krzesinski¹,

Leeman²

2011

RRCC

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Unsatisfactory compliance in the treatment of high blood pressure is frequently due to sequential barriers, such as insufficient patient education about the illness and low motivation to receive any treatment, existence of a large gap between physicians' perceptions of the problem and clinical reality, complexity of the treatment potentially generating adverse effects, and a health care environment with few public education campaigns and incentives for better coordinated supportive care. In order to improve drug compliance, establishment of personalized plans adapted to each patient is required. First, a good doctor-patient relationship is mandatory, with regular education of the patient about hypertension and its risks, discussion about adverse drug effects, and the complexity and cost of treatment. Second, to have any chance of success, the provider should offer convenient appointments and tailor the treatment regimen to the patient's lifestyle and needs, with written instructions. Third, there is a need to promote active patient collaboration with treatment. An innovative combination of home self-measurement of blood pressure, use of new technology options, eg, texting or telemedicine, and creation of a multidisciplinary working team can offer new, effective opportunities. This approach could reduce cardiovascular complications by improving the control of high blood pressure, and thereby the overall costs of hypertension to the health care system.

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Efficacy of a home blood pressure monitoring programme on therapeutic compliance in hypertension: the EAPACUM–HTA study

Abstract: An HBPM programme using electronic monitors is effective in improving compliance in arterial hypertension, measured using the MEMS.

Cited by 142 publications

References 17 publications

Home blood pressure measurements associated with better blood pressure control: the J-HOME study

Home blood pressure measurements associated with better blood pressure control: the J-HOME study

Uncontrolled hypertension based on morning and evening home blood pressure measurements from the J-HOME study

Practical issues in medication compliance in hypertensive patients

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