Carlos Akel

Mobile phone text messaging improves antihypertensive drug adherence in the community

Antihypertensive drug adherence (ADA) is a mainstay in blood pressure control. Education through mobile phone short message system (SMS) text messaging could improve ADA. The authors conducted a randomized study involving 314 patients with hypertension with <6 months of antihypertensive treatment from the Preventive Health Program of 12 different primary care centers in Santiago, Chile. Patients were randomly assigned to receive or not receive SMS related to ADA and healthy lifestyle. Adherence was assessed by the self‐reported four‐item scale Morisky‐Green‐Levine questionnaire at baseline and after 6 months of follow‐up, with four of four positive questions classified as good adherence. Group comparison for adherence was performed by means of a logistic regression model, adjusting by baseline adherence, age older than 60 years, and sex. A total of 163 patients were randomized to receive and 151 to not receive SMS. After 6 months of follow‐up, ADA in the non‐SMS group decreased from 59.3% to 51.4% (P=.1). By contrast, adherence increased from 49% to 62.3% (P=.01) in the SMS group. Text messaging intervention improved ADA (risk ratio, 1.3; 95% confidence interval, 1.0–1.6 [P<.05]). At 6‐month follow‐up, text messaging resulted in an increase in reporting ADA in this hypertensive Latino population. This approach could become an effective tool to overcome poor medication adherence in the community.

Prevalencia y determinantes de adherencia a terapia antihipertensiva en pacientes de la Región Metropolitana

Background: Lack of adherence with medications is the main cause of antihypertensive treatment failure. Aim: To assess adherence to antihypertensive drugs and its determinants. Material and methods: The Morinsky-Green questionnaire to determine treatment adherence was applied to 310 hypertensive patients from primary care centers, aged 60 ± 10 years (65% females) in treatment for 4 ± 1 months. Socio-demographic features, use of medications and quality of life using EQ5D questionnaire were also assessed. Results: Twenty percent of patients were diabetic and 19% were smokers. Fifty four percent were adherent to therapy. A higher age and being unemployed were associated with a higher compliance. The main reasons to justify the lack of adherence were forgetting to take the pills in 67% and adverse effects in 10%. Only diastolic pressure was lower in adherent patients, compared with their non-adherent counterparts (78±12 and 81±17 mmHg, respectively p<0.01). Conclusions: Only half of hypertensive patients comply with their antihypertensive therapy.

Adherencia farmacológica y prevención secundaria cardiovascular: una de las principales barreras en el tratamiento de la enfermedad ateroesclerótica. Posición del Departamento de Prevención Cardiovascular de SOCHICAR en el uso de la polipíldora en prevención secundaria

Revista Chilena de Cardiología Vol. 35 Número 3, Diciembre 2016 Correspondencia: Dra. Mónica Acevedo Cardióloga Departamento de Prevención Cardiovascular, Sociedad Chilena de Cardiología y Prevención Cardiovascular macevedo@med.puc.cl Adherencia farmacológica y prevención secundaria cardiovascular: una de las principales barreras en el tratamiento de la enfermedad ateroesclerótica. Posición del Departamento de Prevención Cardiovascular de SOCHICAR en el uso de la polipíldora en prevención secundaria

Nuevas guías ACC / AHA 2013 en el manejo del colesterol: "Una mirada crítica del Departamento de Prevención Cardiovascular de la Sociedad Chilena de Cardiología y Cirugía Cardiovascular"

El 12 de noviembre del ano 2013, el Colegio Americano de Cardiologia (American College of Cardiology - ACC), en conjunto con la Asociacion Americana del Corazon (American Heart Association - AHA) entregaron las nue-vas guias para el tratamiento de la hipercolesterolemia, con el objetivo de disminuir el riesgo de la enfermedad cardiovascular ateroesclerotica en adultos