The Determinants of Dropping Out of Care Among Hypertensive Patients Receiving a Behavioral Intervention

Predictors of dropping out of care were examined for 171 treated hypertensive patients enrolled in a randomized trial of social support strategies designed to improve compliance and blood pressure control. Control patients who continued to receive routine care were more than twice as likely to drop out as patients who received routine care and periodic home visits by nurses or pharmacists (odds ratio OR = 2.7). The combination of home visits and a second intervention, having family members monitor patients' blood pressure and compliance behavior, was no more effective than home visits alone (OR = 1.1). The home visits intervention was one of six variables identified by a stepwise regression as significant predictors of dropping out. Patients with four or more high-risk characteristics constituted 15% of the sample but contributed almost half (46%) of the dropouts. Targeting support strategies at high-risk patients may be a cost-effective means of reducing uncontrolled hypertension.