What is the clinical evidence from this study?

Study design: Observational. Population: Hypertension (n=161). Intervention: Electronic monitoring vs. Pharmacy refill records. Primary outcome: Agreement between electronic monitoring and refill compliance (Spearman's correlation -0.02, 95% CI -0.18-0.15).

February 17, 2006BMC Health Services ResearchOpen Access

All that glisters is not gold: a comparison of electronic monitoring versus filled prescriptions – an observational study

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Key result

Electronic monitoring and pharmacy refill records showed very little agreement in measuring antihypertensive medication compliance, yielding a Cohen's kappa coefficient of 0.005.

Why the study?

Does electronic monitoring agree with pharmacy refill records for measuring antihypertensive medication compliance in patients with uncontrolled hypertension?

Population

161 patients with a diagnosis of hypertension for at least a year prior to inclusion, and inadequate blood…

Comparison

Electronic monitoring of antihypertensive… vs Refill compliance determined from computerized…

Design

Cohort

Follow-up

2 months

Authors

GWGwenn WetzelsUniversity Hospital of Bern PNPatricia J. NelemansMaastricht University JSJan SchoutenMRC Holland (Netherlands)

Discussion

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Implication

Method comparison for antihypertensive adherence is hypothesis-generating; prospective trials needed before guiding practice.

Study Design

Type

Observational (n=161)

Multicenter

Yes

Structured PICO

Does electronic monitoring agree with pharmacy refill records for measuring antihypertensive medication compliance in patients with uncontrolled hypertension?

Population

161 patients with hypertension and inadequate blood pressure control despite antihypertensive therapy, evaluated for medication compliance using two different measurement methods.

Exposure

Electronic monitoring of antihypertensive medication compliance using Medication Event Monitoring System (MEMS) pillboxes for 2 months, with patients aware of the monitoring.

Comparator

Refill compliance determined from computerized pharmacy records during 12 months before the start of electronic monitoring.

Outcome

Agreement between compliance measured by electronic monitoring and refill compliance, calculated using Spearman's correlation coefficient and Cohen's kappa coefficient.

Main Result

Effect estimate: Spearman's correlation -0.02 (95% CI -0.18-0.15)

Limitations

Short duration of electronic monitoring (two months) and low refilling frequency during this time precluded stable estimation of refill compliance during the monitoring period itself.
The time periods wherein refill and taking compliance were measured differed (12 months prior vs 2 months prospective).
Patients were aware that their medication behavior was being monitored, which may have artificially improved compliance during the electronic monitoring period.
The time periods wherein refill and taking compliance were measured differed (2 months for electronic monitoring vs 12 months for refill compliance).
Historically used cut-off points (e.g., 85%) may be meaningless as some drugs are more forgiving than others in terms of missed dosing and timing of ingestion.

Cite This Study

Wetzels et al. (2006) conducted an observational in Hypertension (n=161). Electronic monitoring vs. Pharmacy refill records was evaluated on Agreement between electronic monitoring and refill compliance (Spearman's correlation -0.02, 95% CI -0.18-0.15). Electronic monitoring and pharmacy refill records showed very little agreement in measuring antihypertensive medication compliance, yielding a Cohen's kappa coefficient of 0.005.

synapsesocial.com/papers/6a6cc7b1febe604dd707980c https://doi.org/10.1186/1472-6963-6-8

Topics

Hypertension management

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All that glisters is not gold: a comparison of electronic monitoring versus filled prescriptions – an observational study

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

All that glisters is not gold: a comparison of electronic monitoring versus filled prescriptions – an observational study

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider