F Alhalaiqa, K H O Deane, A H Nawafleh, A Clark, R Gray, (2011) Adherence therapy for medication non-compliant patients with hypertension: a randomised controlled trial Journal of Human Hypertension 10-1 published on line http://www.nature.com/doifinder/10.1038/jhh.2010.133

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

Objective: To establish the efficacy of Adherence Therapy (AT) compared to treatment as usual (TAU) in reducing blood pressure (BP) in non-compliant hypertensive patients.

Design: Parallel group single blind randomised controlled trial.

Setting: Three General Hospital Outpatient clinics in Jordan.

Participants: 136 non-compliant hypertensive patients with a mean baseline BP of 164.5 mm Hg (sd 10.0) over 102.2 mm Hg (sd 7.0).

Intervention: 7 weekly 20 minute sessions of AT in addition to TAU.

Main outcome: Systolic blood pressure (SBP) at 11 week follow-up.

Results: 68 patients received TAU and 68 AT. Intention-to-treat analysis included all participants randomised. AT lowered SBP by -23.11 mm Hg (95% CI: -25.85, -20.36) and diastolic BP (DBP) by -15.18 mm Hg (95% CI: -17.55, -12.80) at 11 weeks compared to TAU. Adherence (measured by pill counting) was also improved in the AT group by 37% at 11 weeks compared to TAU. No significant adverse events were reported.

Conclusions: Adherence therapy increases adherence to medication for hypertension which then leads to a clinically important reduction in BP.