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[Descriptive study of patient compliance in pharmacologic antihypertensive treatment and validation of the Morisky
A Val Jiménez1, G Amorós Ballestero, P Martínez Visa
1ABS La Gavarra (Cornellà), Unidad Docente de Medicina Familiar y Comunitaria de Barcelona.
Objective:
To ascertain the degree of correct use of a course of medication in a sample of patients with high blood pressure attending Primary Attention consultation, and to validate the Morisk and Green completion test.
Design:
This is a transversal observational study carried out in two stages, which aims to analyse the variable rate of correct following of instructions. The sample was selected at random. SITE. The study was carried out within the framework of Primary Care.
Patients:
The sample was drawn from patients with high blood pressure under treatment by medication, including 96 patients of whom only 86 completed the study.
Main Measurements And Results:
Measurement of the actual incidence of correct use was carried out by means of counting the pills in the patients' homes, and the theoretical incidence of correct use by means of the Morisky and Green Test. We class those who take between 80-110% of the prescribed pills as completing the course correctly. We found: 18.6% took less medication (Margin of reliability (MR) 95%: 10, 3-26.8%), 23% took more than they should (MR 95%: 14.4-32, 2%) and 58.1% took medication as instructed (MR 95%: 48-68%, without significant differences either by sex or age. The test's sensitivity in detecting those who complied with instructions was 52%, and specificity was 44.4%.
Conclusions:
1. The number of over-consumers is particularly notable. 2. Responses to the test do not show any relationship with correct use of medication in this study. 3. In our view the test could only be used in a hypothetical population where there were no over-consumers.