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The feasibility of the PAM intervention to support treatment-adherence in people with hypertension in primary care. A randomised clinical controlled trial

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Authors

  • Aikaterini Kassavou
  • Venus Mirzaei
  • Sonia Shpendi
  • James Brimicombe
  • Jagmohan Chauhan
  • Helen Eborall
  • Miranda van Emmenis
  • Anna De Simoni
  • Amrit Takhar
  • Pankaj Gupta
  • Prashanth Patel
  • Cecilia Mascolo
  • Andrew Toby Prevost
  • Stephen Morris
  • Simon Griffin
  • Richard J. McManus
  • Jonathan Mant
  • Stephen Sutton

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Abstract

The PAM intervention is a behavioural intervention to support adherence to anti-hypertensive medications and therefore to lower blood pressure. This feasibility trial recruited 101 nonadherent patients (54% male, mean age 65.8 years) with hypertension and high blood pressure from nine general practices in the UK. The trial had 15.5% uptake and 7.9% attrition rate. Patients were randomly allocated to two groups: the intervention group (n = 61) received the PAM intervention as an adjunct to usual care; the control group (n = 40) received usual care only. At 3 months, biochemically validated medication adherence was improved by 20% (95% CI 3-36%) in the intervention than control, and systolic blood pressure was reduced by 9.16 mmHg (95% CI 5.69-12.64) in intervention than control. Improvements in medication adherence and reductions in blood pressure suggested potential intervention effectiveness. For a subsample of patients, improvements in medication adherence and reductions in full lipid profile (cholesterol 1.39 mmol/mol 95% CI 0.64-1.40) and in glycated haemoglobin (3.08 mmol/mol, 95% CI 0.42-5.73) favoured the intervention. A larger trial will obtain rigorous evidence about the potential clinical effectiveness and cost-effectiveness of the intervention.Trial registration Trial date of first registration 28/01/2019. ISRCTN74504989. https://doi.org/10.1186/ISRCTN74504989 .

Details

Original languageEnglish
Article number8897
JournalScientific Reports
Volume11
DOIs
Publication statusPublished - 26 Apr 2021
Peer-reviewedYes

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