Het belang van thuis bloeddruk meter

Efficacy of a home blood pressure monitoring programme on therapeutic compliance in hypertension: the EAPACUM-HTA study.

J Hypertens. 2006 Jan;24(1):169-75.
Marquez-Contreras E, Martell-Claros N, Gil-Guillen V, de la Figuera-Von Wichmann M, Casado-Martinez JJ, Martin-de Pablos JL, Figueras M, Galera J, Serra A; Compliance Group of the Spanish Society of Hypertension (SEE).
La Orden Health Centre, Huelva, Spain.

OBJECTIVE: To evaluate the efficacy of a programme of home blood pressure measurement (HBPM) on therapeutic compliance in mild-to-moderate hypertension.

DESIGN: A prospective controlled multicentre clinical trial.

SETTING: Forty primary care centres in Spain, with a duration of 6 months.

PATIENTS: A total of 250 patients with newly diagnosed or uncontrolled hypertension were included.

INTERVENTIONS: The patients were randomly selected and distributed in two groups: (1) the control group (CG) who received standard health intervention; (2) the intervention group (IG): the patients in this group received a blood pressure monitor in their homes for a programme of HBPM.

MAIN OUTCOME MEASURE: Four visits were scheduled, for the measurement of blood pressure (BP). They were provided with an electronic monitor for measuring compliance (monitoring events medication system; MEMS). Therapeutic compliance was defined as a drug consumption of 80-110%. A number of variables were calculated using the MEMS. The mean BP were calculated and the percentage of controlled patients.

RESULTS: A total of 200 patients completed the study (100 in each group). Compliance was observed in 74 and 92%, respectively, in the CG and IG [95% confidence interval (CI) 63.9-84.1 and 86.7-97.3; P = 0.0001], the mean percentage compliances were 87.6 and 93.5% (95% CI 81.2-94 and 80.7-98.3; P = 0.0001), the percentages of correct days were 83.6 and 89.4%, the percentages of subjects who took the medication at the prescribed time were 79.89 and 88.06%, and the levels of therapeutic cover were 86.7 and 93.1%. The number needed to treat to avoid one case of non-compliance was 5.6 patients. The differences in the mean decreases in BP were significant for diastolic BP, with a greater decrease observed in the IG.

CONCLUSIONS: An HBPM programme using electronic monitors is effective in improving compliance in arterial hypertension, measured using the MEMS.