Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2006 Feb 10:6:8.
doi: 10.1186/1472-6963-6-8.

All that glisters is not gold: a comparison of electronic monitoring versus filled prescriptions--an observational study

Gwenn E C Wetzels  1 , Patricia J Nelemans, Jan S A G Schouten, Boris L G van Wijk, Martin H Prins
Affiliations
Comparative Study

All that glisters is not gold: a comparison of electronic monitoring versus filled prescriptions--an observational study

Gwenn E C Wetzels et al. BMC Health Serv Res. .

Abstract

Background: Poor compliance with antihypertensive medication is assumed to be an important reason for unsatisfactory control of blood pressure. Poor compliance is difficult to detect. Each method of measuring compliance has its own strengths and weaknesses. The aim of the present study was to compare patient compliance with antihypertensive drugs as measured by two methods, electronic monitoring versus refill compliance.

Methods: 161 patients with a diagnosis of hypertension for at least a year prior to inclusion, and inadequate blood pressure control (systolic blood pressure > or = 160 mmHg and/or diastolic blood pressure > or = 95 mmHg) despite the use of antihypertensive drugs, were included. Patients' pharmacy records from 12 months prior to inclusion were obtained. Refill compliance was calculated as the number of days for which the pills were prescribed divided by the total number of days in this period. After inclusion compliance was measured with an electronic monitor that records time and date of each opening of the pillbox. Agreement between both compliance measures was calculated using Spearman's correlation coefficient and Cohen's kappa coefficient.

Results: There was very little agreement between the two measures. Whereas refill compliance showed a large range of values, compliance as measured by electronic monitoring was high in almost all patients with estimates between 90% and 100%. Cohen's kappa coefficient was 0.005.

Conclusion: While electronic monitoring is often considered to be the gold standard for compliance measurements, our results suggest that a short-term electronic monitoring period with the patient being aware of electronic monitoring is probably insufficient to obtain valid compliance data. We conclude that there is a strong need for more studies that explore the effect of electronic monitoring on patient's compliance.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Comparison of refill compliance versus electronic monitoring (taking compliance).
See this image and copyright information in PMC

References

    1. Mar J, Rodriguez-Artalejo F. Which is more important for the efficiency of hypertension treatment: hypertension stage, type of drug or therapeutic compliance? J Hypertens. 2001;19:149–155. doi: 10.1097/00004872-200101000-00020. - DOI - PubMed
    1. O'Rorke JE, Richardson WS. Evidence based management of hypertension: What to do when blood pressure is difficult to control. Bmj. 2001;322:1229–1232. doi: 10.1136/bmj.322.7296.1229. - DOI - PMC - PubMed
    1. Urquhart J. Partial compliance in cardiovascular disease: risk implications. Br J Clin Pract Suppl. 1994;73:2–12. - PubMed
    1. WHO Adherence to long-term therapies: evidence for action. WHO. 2003. - PubMed
    1. De Klerk E. Measurement of patient compliance on drug therapy: an overview. In: Vingerhoets A, editor. Advances in behavioral medicine assesment. , Harwood academic Publishers; 2001.

Publication types

Substances