Adherence therapy for medication non-compliant patients with hypertension: a randomised controlled trial

The objective of this study is to establish the efficacy of adherence therapy (AT) compared with treatment as usual (TAU) in reducing blood pressure (BP) in noncompliant hypertensive patients. This study was designed as a parallel-group single-blind randomised controlled trial. The study was carried out at three general hospital outpatient clinics in Jordan. A total of 136 non-compliant hypertensive patients with a mean baseline BP of 164.5mmHg (s.d. 10.0) over 102.2 mmHg (s.d. 7.0) participated in the study. 7 weekly 20-min sessions of AT in addition to TAU. The main outcome of this study is systolic blood pressure (SBP) at 11-weeks follow-up. In all, 68 patients received TAU and 68 AT. Intention-to-treat analysis included all participants randomised. AT lowered SBP by -23.11mmHg (95% CI: -25.85, -20.36) and diastolic BP (DBP) by -15.18mmHg (95% CI: -17.55, -12.80) at 11 weeks compared with TAU. Adherence (measured by pill counting) was also improved in the AT group by 37% at 11 weeks compared with TAU. No significant adverse events were reported. AT increases adherence to medication for hypertension which then leads to a clinically important reduction in BP. Journal of Human Hypertension (2012) 26, 117-126; doi:10.1038/jhh.2010.133; published online 17 February 2011