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Measuring adherence in a hypertension clinical trial . BACKGROUND Non-adherence in hypertension is a global problem and promoting adherence is necessary to decrease cardiovascular mortality . AIMS The purpose of this paper is to examine the measurement of adherence to medication taking in hypertensive patients . Adherence was evaluated primarily by means of MEMS ( Medication Event Monitoring System , Aprex Corporation , Fremont , California ) an electronic system that records the date and time of opening of the study medication container . Additional measurements such as change in urinary potassium level , capsule count , client self report and physician estimate of adherence were recorded . METHODS A randomised clinical trial was used to assign patients to receive the study medication ( potassium ) or placebo . Descriptive statistics were used to answer the research questions . Frequency and percentage of responses to different measures of adherence were carried out as well as correlation between the measures . RESULTS One hundred and seven subjects between the ages of 26 and 80 participated in the clinical trial . The results showed that adherence measures varied with lowest adherence from two items of self-report related to forgetfulness ( 46 and 55 % ) and stringent electronic monitoring with the MEMS ( 58 % ) to percentages in the 80-90 range for other self-report items and the general adherence scale . Electronic monitoring correlated best with capsule count at visit 5 . Implications for health care providers are discussed .
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Intervention_Pharmacological
medication
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Intervention_Pharmacological
study medication ( potassium )
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Intervention_Control
placebo
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Outcome_Mental
adherence
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Outcome_Mental
MEMS ( Medication Event Monitoring System
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Outcome_Physical
urinary potassium level
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Outcome_Physical
capsule count
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Outcome_Mental
client self report and physician estimate of adherence
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Outcome_Physical
adherence
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Outcome_Physical
self-report related to forgetfulness
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Outcome_Physical
electronic monitoring with the MEMS
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Outcome_Physical
capsule count
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Participant_Condition
hypertension
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Participant_Condition
hypertensive
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Participant_Sample-size
One hundred and seven
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Participant_Age
26 and 80