NONCOMPLIANCE WITH SCHEDULED VISITS IN ARTERIAL-HYPERTENSION - PROFILE OF THE NONCOMPLIANT PATIENT

Objective. To know the non-compliance of hypertensive patients with sc heduled visits, to define the patient profile, and to study the best m ethod which identifies such patients. Patients and methods. A total of 174 hypertensive patients under pharmacological therapy in the Primar y Care setting. Non-compliance with scheduled visits was assessed by r eview of the appointment book. The characteristics of patients, of the disease, and therapy associated with non-compliance were studied and six indirect methods were validates. Results. The profile of the non-c ompliant patient corresponded to a housewife or with working activity (p = 0.01), obesity (p = 0.01), anxiety (p = 0.008), moderate-severe c ardiovascular risk (p = 0.02), bad control of blood pressure values (p = 0.03), and physician's dependence (p = 0.001). Of the investigated methods, education level (EL) had the highest sensitivity (77.8%) (CI: 65.7%-89.9%) and medical judgement (MJ) the highest specificity (87.6 ; CI: 81.9%-93.3%), negative predictive value 80.1%, positive predicti ve value 51.5%, odds ratio of low compliance 3.1 and best Kappa index 0.28. Conclusions. Factors predicting non-compliance are few but delin eate a possible profile. Only MJ is valid to detect non-compliance wit h scheduled visits.