Patient-reported adherence to guidelines of the Sixth Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure

Objectives. To compare antihypertensive drug compliance with treatment guid elines established by the Sixth joint National Committee on Prevention, Det ection, Evaluation, and Treatment of High Blood Pressure (JNC VI), and to i dentify patient adherence to antihypertensive drugs and factors affecting p rescribing patterns. Methods. Patients filling antihypertensive drug prescriptions in metropolit an New York area pharmacies were enrolled. Pharmacy externs collected patie nt-reported demographics, medical and drug histories, and blood pressure me asurements. Compliance with JNC VI guidelines was assessed. Results. Eight hundred twenty-one patients from 102 pharmacies participated . Blood pressure was controlled in 61% of patients at the time of the study . The most prescribed class of antihypertensive agents was angiotensin-conv erting enzyme inhibitors, followed by diuretics and beta -blockers. Over th e study period, compliance with JNC VI guidelines decreased significantly f rom 85% to 64% (p < 0.05). Thirty-seven percent of patients reported consis tent adherence to their antihypertensive regimens. Patients' education leve l was the only factor found to correlate positively with the appropriatenes s of antihypertensive agents prescribed. Conclusion. Compliance with JNC VI guidelines decreased over time, and pati ent adherence to drug therapy was suboptimal. Continuing-education efforts to reinforce optimal blood pressure management are necessary.