Compliance of hypertensive patients is primarily estimated in participating patients in clinical trials. Although compliance is overestimated by pill-counting, this technique is most frequently used. 389 Austrian general practitioners studied compliance in 945 hypertensives, using the Medication Event Monitoring System. The patients were asked to take the ACE-inhibitor Cilacapril once a day between 7.00 a.m. and 9.00 a.m. Each package opening was registered by a microprocessor located in the cover of the drug vial. In this study it turned out that only 1.3% of the patients did open their vials between 7.00 a.m. and 9.00 a.m. 2 thirds of the patients actually took less than 80% and 36% less than half of the prescribed medication. There was no correlation between compliance and sex, age, smoking habits, tolerance or duration of hypertension. Even fall in blood pressure was the same in compliant and non compliant patients. The conclusion is that compliance is bad in a general practitioner setting and further more that casual readings as performed in this study are an insufficient tool to judge efficacy.
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