ENHANCEMENT OF COMPLIANCE AMONG PATIENTS WITH HYPERTENSION

Studies of patient compliance with medical advice consistently demonst rate a high level of noncompliance. Not following recommendations can have serious negative consequences in the management of disease. This study was an assessment of the effect on compliance of a longitudinal, individualized educational program for patients with hypertension in a managed care setting. A before-and-after self-paired design was used to assess the behavior of 107 patients with hypertension, Trained nur ses using an interactive interview format reinforced prescribed treatm ent and provided appropriate printed material to participants, Brief t elephone follow-up interviews at prescribed intervals were used to eli cit problems, provide additional education, and reinforce compliance b ehaviors. Most of the patients who participated showed a statistically significant (P < 0.01) decrease in both systolic and diastolic blood pressure. There was also an effect on various recommended behaviors, i ncluding compliance with medication taking, ideal body weight, salt re striction, stress, and exercise. A statistically significant relation existed between improved compliance with individual behavior changes a nd decreased blood pressure (P < 0.01). Elderly persons were particula rly likely to show statistically significant reductions in blood press ure (75.4% versus 50.0%). A chi(2) test indicated that those differenc es were significant at the 0.01 level. A relatively inexpensive, offic e-based educational protocol can have a statistically significant effe ct on treatment compliance among patients with hypertension. The inter vention has particular implications for geriatric patients, whose high blood pressure is disproportionately represented.