Relationship between daily dose frequency and adherence to antihypertensive pharmacotherapy: Evidence from a meta-analysis

Iskedjian, Michaël; Einarson, Thomas R.; MacKeigan, Linda; Shear, Neil H.; Addis, Antonio; Mittmann, Nicole; Ilersich, A. Lane

doi:10.1016/s0149-2918(02)85026-3

Cited by 255 publications

(167 citation statements)

References 19 publications

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“…This result partly supported the hypothesis that reduced call frequency would be associated with increased rates of compliance. Thus with the relaxed window, the overall (numerically) highest rate of compliance was observed with the OD schedule -consistent with the theory that once-daily dosing is superior to more frequent dosing regimens [13][14][15][16][17]. Indeed, the rate of completed calls within the relaxed window was considerably higher (38% to 60%) for the OD schedule than for the TID schedule.…”

Section: Discussionsupporting

confidence: 78%

“…IVRS acted as a suitable model of medication dosing since, in accordance with the literature, OD dosing was associated with improved compliance compared with BID or TID dosing [13][14][15][16][17]. A key advantage of this model is that the selected SRT and CRT modules took approximately 2 minutes each to complete -simulating the time required to take a dose of medication.…”

Section: Discussionmentioning

confidence: 99%

“…There is some evidence (although inconsistent) that reducing dosing frequency may enhance compliance [13][14][15][16][17]. However, this evidence generally comes from Page 7 of 25…”

Section: Introductionmentioning

confidence: 99%

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A randomized trial to determine the impact on compliance of a psychophysical peripheral cue based on the Elaboration Likelihood Model

Horton

Minniti

Mireylees

et al. 2008

Contemporary Clinical Trials

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Objective: Non-compliance in clinical studies is a significant issue, but causes remain unclear.Utilizing the Elaboration Likelihood Model of persuasion, this study assessed the psychophysical peripheral cue 'Interactive Voice Response System (IVRS) call frequency' on compliance.Methods: 71 participants were randomized to once daily (OD), twice daily (BID) or three times daily (TID) call schedules over two weeks. Participants completed 30-item cognitive function tests at each call.Compliance was defined as proportion of expected calls within a narrow window (±30 min around scheduled time), and within a relaxed window (-30 min to +4 hour). Data were analyzed by ANOVA and pairwise comparisons adjusted by the Bonferroni correction.Results: There was a relationship between call frequency and compliance. Bonferroni adjusted pairwise comparisons showed significantly higher compliance (p=0.03) for the BID (51.0%) than TID (30.3%) for the narrow window; for the extended window, compliance was higher (p=0.04) with OD (59.5%), than TID (38.4%).Conclusion: The IVRS psychophysical peripheral cue call frequency supported the ELM as a route to persuasion. The results also support OD strategy for optimal compliance. Models suggest specific indicators to enhance compliance with medication dosing and electronic patient diaries to improve health outcomes and data integrity respectively.Response to Reviewers: Sincerest thanks to the reviewers for providing feedback. Each comment has been addressed either in the manuscript or is shown below. 2. 'Participants (N=71), were randomized using an IVRS in the ratio 1:1:1 to a OD, BID or TID call schedule'.How did authors divide them according to 1:1:1? Explanatory text has been added to page 8. Please note that randomization was not stratified.3. '44 (62%) completed the study (Fig.1). Participants who prematurely discontinued were not followed up, so reasons for withdrawal are unknown'. Just 44 of 71 participants completed study, the quality of it should be susceptible.The authors recognize that the completion rate is lower than perhaps might be considered ideal. However it should be noted that 78% of participants randomized to once-daily calls completed the study compared to 43% of participants randomized to three-times daily calls. This difference in completion rates supports our findings for the primary endpoint, given that the once-daily call schedule was associated with the highest rate of compliance (with the relaxed window). Additional text has been added to the discussion (page 16) to raise this point.4. The discussion should be concise; the conclusion should be cautious.The discussion and conclusion have been shortened, to ensure that only the key points from the study are discussed, and to remove some of the aspects of the conclusions that generalised the findings of the study in a clinical study context. See pages 15-20.Reviewer 2 Define "electronic patient diaries "A definition has been added to page 5. Define "Interactive Voice Response systems "A definition has ...

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A randomized trial to determine the impact on compliance of a psychophysical peripheral cue based on the Elaboration Likelihood Model

Horton

Minniti

Mireylees

et al. 2008

Contemporary Clinical Trials

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“…Even more longterm benefits may eventually be expected, because the number of drugs an individual is taking per day is an important predictor of adherence to antihypertensive therapy. 31 Interestingly, the benefits of 24-h blood pressure measurement in this study seem to be limited to individuals with previously known hypertension. The reason for this observation is unclear.…”

Section: Discussionmentioning

confidence: 81%

Twenty-four hour ambulatory blood pressure for the management of antihypertensive treatment: a randomized controlled trial

2008

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The aim of this study was to assess whether the use of 24-h blood pressure (BP) measurement in the management of antihypertensive therapy improves BP in patients with sustained hypertension. Patients with sustained hypertension (office BP X140/90 mm Hg, and 24-h systolic BP X130/80 mm Hg) were randomly assigned to a strategy using 24-h BP to manage antihypertensive treatment (target o130/80 mm Hg) or to a standard strategy using office BP (target o140/90 mm Hg). The primary end point was change in 24-h systolic BP at 1 year of follow-up. We included 136 patients in the primary analysis. After 1 year of follow-up, the change in 24-h systolic BP was significantly greater in the ambulatory BP group compared with the office BP group (mean difference (95% confidence interval) À3.6 (À7.0, À0.3), P ¼ 0.03). Intentionto-treat analysis revealed essentially unchanged results.The mean number of antihypertensive drugs per participant at 1 year of follow-up was 1.76 ± 1.1 and 1.95 ± 0.9 in the ambulatory and office BP group, respectively (P ¼ 0.049). The benefit of ambulatory BP monitoring was mainly seen in patients with previously known hypertension (mean difference À7.2 (À11.6, À2.8), P ¼ 0.002), but not in those with newly detected hypertension (mean difference 0.2 (À4.9, 5.4), P ¼ 0.93). In conclusion, using 24-h BP for the management of antihypertensive therapy in patients with sustained hypertension leads to a greater BP reduction compared with a standard treatment strategy using office BP, although fewer antihypertensive drugs were used in the ambulatory BP group.

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“…The number of medicines prescribed may also influence compliance, with a reduction in compliance as the regime becomes more complex. 5 These factors alone do not provide a full explanation of patients' decisions and behaviour. In order to do this, health beliefs in compliance have also been studied.…”

Section: Introductionmentioning

confidence: 99%

Patient compliance in hypertension: role of illness perceptions and treatment beliefs

2004

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Despite many years of study, questions remain about why patients do or do not take medicines and what can be done to change their behaviour. Hypertension is poorly controlled in the UK and poor compliance is one possible reason for this. Recent questionnaires based on the self-regulatory model have been successfully used to assess illness perceptions and beliefs about medicines. This study was designed to describe hypertensive patients' beliefs about their illness and medication using the self-regulatory model and investigate whether these beliefs influence compliance with antihypertensive medication. We recruited 514 patients from our secondary care population. These patients were asked to complete a questionnaire that included the Beliefs about Medicines and Illness Perception Questionnaires. A case note review was also undertaken. Analysis shows that patients who believe in the necessity of medication are more likely to be compliant (odds ratio (OR)) 3.06 (95% CI 1.74-5.38), Po0.001). Other important predictive factors in this population are age ), Po0.001), emotional response to illness (OR 0.65 (0.47-0.90), P ¼ 0.01) and belief in personal ability to control illness (OR 0.59 (0.40-0.89), P ¼ 0.01). Beliefs about illness and about medicines are interconnected; aspects that are not directly related to compliance influence it indirectly. The self-regulatory model is useful in assessing patients health beliefs. Beliefs about specific medications and about hypertension are predictive of compliance. Information about health beliefs is important in achieving concordance and may be a target for intervention to improve compliance.

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Relationship between daily dose frequency and adherence to antihypertensive pharmacotherapy: Evidence from a meta-analysis

Cited by 255 publications

References 19 publications

A randomized trial to determine the impact on compliance of a psychophysical peripheral cue based on the Elaboration Likelihood Model

A randomized trial to determine the impact on compliance of a psychophysical peripheral cue based on the Elaboration Likelihood Model

Twenty-four hour ambulatory blood pressure for the management of antihypertensive treatment: a randomized controlled trial

Patient compliance in hypertension: role of illness perceptions and treatment beliefs

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