| Monitoring adherence to medication by measuring change in blood pressure. | |
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MedLine Citation:
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PMID: 20696980 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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After starting antihypertensives, blood pressure is monitored for several reasons, including assessment of adherence. We aimed to estimate the accuracy of blood pressure monitoring for detecting early nonadherence. We conducted a secondary analysis of the Perindopril Protection Against Recurrent Stroke Study (PROGRESS), a large randomized trial of blood pressure lowering to reduce the risk of recurrent stroke. We compared change in blood pressure 3 months after randomization in people who had discontinued treatment (nonadherent) with those who stayed on treatment (adherent). We also used an indirect method, assessing whether change in blood pressure discriminated between active (adherent) and placebo (nonadherent) groups. Both methods gave similar results. For the 3433 subjects, the mean (SD) of the change in systolic blood pressure was -15.8 mm Hg (SD 18.7 mm Hg) in the adherent group and -4.2 mm Hg (SD 18.1 mm Hg) in the nonadherent group. After recalibration of the mean change in the nonadherent group to 0 mm Hg and in the adherent group to -11.6 mm Hg, the absence of a fall in systolic blood pressure at 3 months had a sensitivity of 50% and a specificity of 80% for detecting nonadherence (50% of nonadherent patients and 20% of adherent patients had a rise in blood pressure). Discriminatory power was modest over the range of cutoffs (area under the receiver-operator curve 0.67). Monitoring blood pressure is poor at detecting nonadherence to blood pressure-lowering treatment. Further research should look at other methods of assessing adherence. |
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Authors:
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Andrew Hayen; Katy Bell; Paul Glasziou; Bruce Neal; Les Irwig |
Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2010-08-09 |
Journal Detail:
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Title: Hypertension Volume: 56 ISSN: 1524-4563 ISO Abbreviation: Hypertension Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-16 Completed Date: 2010-10-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7906255 Medline TA: Hypertension Country: United States |
Other Details:
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Languages: eng Pagination: 612-6 Citation Subset: IM |
Affiliation:
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Sydney School of Public Health A27, University of Sydney, Sydney, NSW 2006, Australia. andrew.hayen@sydney.edu.au |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angiotensin-Converting Enzyme Inhibitors
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therapeutic use Blood Pressure / drug effects* Diuretics / therapeutic use Drug Monitoring / methods Drug Therapy, Combination Female Follow-Up Studies Humans Hypertension / drug therapy*, physiopathology Indapamide / therapeutic use* Male Patient Compliance Perindopril / therapeutic use* Stroke / prevention & control Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin-Converting Enzyme Inhibitors; 0/Diuretics; 26807-65-8/Indapamide; 82834-16-0/Perindopril |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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