Korean Circ J.  2005 Nov;35(11):821-826. 10.4070/kcj.2005.35.11.821.

Study of Compliance to Antihypertensive Medication in Korean Hypertensive Patients Using Medication Event Monitoring System

• Sung J
• Choi JH
• On YK
• Lee SC
• Park SW
• Gwon HC
• Jeon ES
• Kim JS
• Kim DK
• Lee SH
• Hong KP
• Park JE
• Seo JD

• KMID: 2297960
• DOI: http://doi.org/10.4070/kcj.2005.35.11.821

Abstract

BACKGROUND AND OBJECTIVES
Compliance to a prescribed antihypertensive regimen influences the management of hypertension in various steps, but studies on this issue are very rare in Korea. The medication event monitoring system (MEMS) is the gold standard in measurement of compliance, which is a special pill container, designed to electronically monitor drug intake patterns. Here, the authors investigated the compliance to the antihypertensive regimen in the cardiology practice of a tertiary care hospital using the MEMS.
SUBJECTS AND METHODS
Monitoring using the MEMS was performed in 80 hypertensive patients during monotherapy. Demographic, clinical and psychological profiles were collected through a standardized questionnaire. The parameters used for compliance were the percentage of doses taken (PDT) and the percentage of doses taken correctly (PDTc), according to the prescribed regimen.
RESULTS
The mean age of the patients and duration of monitoring were 53+/-10 years and 60+/-26 days, respectively. The median and range for the PDT and PDTc were 97% (88-100%) and 92% (80-97%), respectively. About 16% of patients showed relatively poor compliance (PDT<80%). Predicting factors for poor compliance were a recent history of self-discontinuation of drug treatment, not currently being on medication and a young age (p<0.05). Agreement between intuitive prediction by the physician and the actual compliance was closer to what would be expected by chance (kappa coefficient=-0.11).
CONCLUSION
Although average compliance to the single drug antihypertensive regimen was relatively high in the cardiology practice of the tertiary care hospital in this study, a significant proportion of patients show low compliance. Special consideration should be given to patients with factors predictive of poor compliance. Investigation of compliances in other clinical settings is also warranted.

Keyword

Patient compliance; Hypertension; Drug therapy

MeSH Terms

Cardiology
Compliance*
Drug Therapy
Humans
Hypertension
Korea
Micro-Electrical-Mechanical Systems
Patient Compliance
Tertiary Healthcare
Surveys and Questionnaires