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      Adherencia a la medicación mediante el uso del teléfono en pacientes hipertensos crónicos Translated title: Use of the telephone to optimize adherence to medication in chronic hypertensive patients

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          Abstract

          Resumen Introducción . La mitad de los pacientes hipertensos abandona la terapia a partir del primer año del diagnóstico. El uso del teléfono para mejorar la adherencia es aceptado por los pacientes, a través del envío de mensajes a sus celulares o de llamadas telefónicas concertadas, para hacerles recordar la toma de medicación o información sobre su enfermedad. Objetivo . Evaluar la adherencia al tratamiento mediante recordatorio por teléfono en pacientes hipertensos que retiran sus medicamentos de una Clínica de la seguridad social en Paraguay. Metodología: Estudio cuasi experimental; aplicando una encuesta y seguimiento mediante contacto telefónico para evaluar la adherencia a la terapia. Resultados: El 50% (n=11) de los pacientes se clasificaron como no adherentes a la terapia farmacológica; al final de las intervenciones se redujo a 9,1%. La causa principal de la falta de adherencia fue el olvido, 90,9%. La adherencia al tratamiento mejoro significativamente luego de las intervenciones. Conclusión: La utilización de la tecnología podría constituirse en una herramienta para la prevención primaria en la población con factores de riesgo, y el seguimiento de pacientes con hipertensión arterial.

          Translated abstract

          Abstract Introduction: Half of hypertensive patients drop out of therapy from the first year of diagnosis. The use of the telephone to improve adherence is accepted by patients, through sending messages to their cell phones or concerted phone calls, to remind them of taking medication or information about their disease. Objective: This work evaluated the use of technology to optimize the adherence of hypertensive patients who withdraw their medicines from a social security clinic in Paraguay. Methodology: Quasi-experimental study; applying a survey and follow-up through telephone contact to evaluate adherence to therapy. Results: 50% (n=11) of patients were classified as non-adherent to drug therapy; at the end of the interventions it was reduced to 9.1%. The main cause of the lack of adherence was forgetfulness, 90.9%. Adherence to treatment improved significantly after interventions. Conclusion: The use of technology could be a tool for primary prevention in the population with risk factors, and the monitoring of patients with blood pressure.

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          Predictive Validity of a Medication Adherence Measure in an Outpatient Setting

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            Improving treatment adherence for blood pressure lowering via mobile phone SMS-messages in South Africa: a qualitative evaluation of the SMS-text Adherence SuppoRt (StAR) trial

            Background Effective use of proven treatments for high blood pressure, a preventable health risk, is challenging for many patients. Prompts via mobile phone SMS-text messaging may improve adherence to clinic visits and treatment, though more research is needed on impact and patient perceptions of such support interventions, especially in low-resource settings. Method An individually-randomised controlled trial in a primary care clinic in Cape Town (2012–14), tested the effect of an adherence support intervention delivered via SMS-texts, on blood pressure control and adherence to medication, for hypertensive patients. (Trial registration: ClinicalTrials.gov NCT02019823). We report on a qualitative evaluation that explored the trial participants’ experiences and responses to the SMS-text messages, and identified barriers and facilitators to delivering adherence support via patients’ own mobile phones. Two focus groups and fifteen individual interviews were conducted. We used comparative and thematic analysis approaches to identify themes and triangulated our analysis amongst three researchers. Results Most participants were comfortable with the technology of using SMS-text messages. Messages were experienced as acceptable, relevant and useful to a broad range of participants. The SMS-content, the respectful tone and the delivery (timing of reminders and frequency) and the relational aspect of trial participation (feeling cared for) were all highly valued. A subgroup who benefitted the most, were those who had been struggling with adherence due to high levels of personal stress. The intervention appeared to coincide with their readiness for change, and provided practical and emotional support for improving adherence behaviour. Change may have been facilitated through increased acknowledgement of their health status and attitudinal change towards greater self-responsibility. Complex interaction of psycho-social stressors and health service problems were reported as broader challenges to adherence behaviours. Conclusion Adherence support for treatment of raised blood pressure, delivered via SMS-text message on the patient’s own phone, was found to be acceptable, relevant and helpful, even for those who already had their own reminder systems in place. Our findings begin to identify for whom and what core elements of the SMS-text message intervention appear to work best in a low-resource operational setting, issues that future research should explore in greater depth. Electronic supplementary material The online version of this article (doi:10.1186/s12875-015-0289-7) contains supplementary material, which is available to authorized users.
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              Improving blood pressure control in a pharmacist-managed hypertension clinic.

              To determine whether pharmaceutical care provided by a pharmacist-managed hypertension clinic results in better treatment outcomes when compared with traditional health care from a primary care physician. Prospective, controlled study Veterans Affairs Medical Center, Philadelphia, Pennsylvania. Fifty six patients with essential hypertension; 27 were randomly assigned to the intervention group and 29 to the control group. Patients in the intervention group were scheduled monthly to meet with a clinical pharmacist who made appropriate changes in prescribed drugs, adjusted dosages, and provided drug counseling in accordance with the hypertension guidelines in the sixth report of the Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI). Patients in the control group received standard care from their physicians. The study period was 6 months. Treatment outcomes were measured by changes in compliance, blood pressure, and patient satisfaction. The Short Form-36 health survey and a patient satisfaction survey were used to measure changes in patient satisfaction, and a compliance evaluation survey measured compliance. Twenty-one (81%) patients in the intervention group attained their blood pressure goal of below 140/90 mm Hg at the completion of the study versus only eight (30%) in the control group (p < 0.0001). Of 11 patients with diabetes in the intervention group, 10 (91%) attained their blood pressure goal (< 130/80 mm Hg) versus only two (12 %) of 16 patients with diabetes in the control group (p < 0.0001). No significant differences in patient satisfaction or compliance were reported between the intervention and control groups. Pharmaceutical care improves blood pressure control and results in more patients with hypertension reaching their blood pressure goal.
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                Author and article information

                Journal
                rcfb
                Revista CON-CIENCIA
                Rev.Cs.Farm. y Bioq
                Facultad de Ciencias Farmacéuticas y Bioquímicas; Universidad Mayor de San Andrés (La Paz, , Bolivia )
                2310-0265
                June 2022
                : 10
                : 1
                : 17-32
                Affiliations
                [4] orgname
                [1] orgname
                [2] orgname
                [3] orgname
                Article
                S2310-02652022000100017 S2310-0265(22)01000100017
                10.53287/tmph6198gn62f
                caa37af6-bfdb-4d13-8bf1-aa4637caa9d5

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 24 September 2021
                : 03 June 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 21, Pages: 16
                Product

                SciELO Bolivia

                Categories
                ARTÍCULOS ORIGINALES

                adherence,technology,arterial hypertension,tecnología,adherencia,intervención farmacéutica,hipertensión arterial

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