BEHAVIOR OF PATIENTS WITH MILD-TO-MODERAT E HYPERTENSION IN RELATION TO THEIR TREATMENT - VALUE OF AN ELECTRONIC PILLBOX

The objective of the MACH1 study (MEMS for the Assessment of complianc e of Hypertensives) was to evaluate the real behaviour of patients in relation to antihypertensive treatment administered as a single daily dose. After a 2-week period during which no other antihypertensive was allowed to be administered, 590 patients with mild-to-moderate hypert ension received 2 mg of trandolapril as a single daily dose in the mor ning between 7:00 a.m. and 9:00 a.m. for 4 weeks. Treatment was packag ed in electronic pillboxes recording the date and time of each opening . Various profiles were distinguished on the basis of the individual c hronograms for the 501 patients able to be analysed in terms of compli ance, and as a function of the deviations observed in relation to the treatment regimen prescribed. One hundred and two patients (20 %) omit ted more than 20 % of the prescribed doses, either consecutive doses o r scattered throughout the month of treatment; these patients were ref erred to as ''emitters''. The other patients were classified according to the scatter of openings in relation to the mean time of the dose: 10 ''metronome'' patients (2 %), 126 regular patients (25 %), 221 irre gular,, patients (44 %) and 42 ''anarchic'' patients (8 %). Irregulari ties of dose times were more frequent on public holidays than on week days and in patients living in Paris or the Paris region. ''Metronome' ' patients were older than the overall patient population. The use of an electronic pillbox could allow the attending physician to more adeq uately adapt his therapeutic approach and management of specific probl ems of compliance observed in hypertensive patients.