| Abstract: | Noncompliance with follow-up is a serious problem in the management of hypertension. A retrospective cohort study examined dropout rates and their determinants among 249 randomly selected outpatients with essential hypertension from the medical clinic of an urban teaching hospital. Data were abstracted from hospital records and a subset of dropouts was interviewed. A lifetable analysis revealed that patients who were initiating therapy or who had been under therapy for less than six months had a 50% chance of remaining in care two years later, while 70% of patients who had been under therapy for more than six months at entry were still in care after this period. Patients who were less severely ill by several indicators were the most likely to drop out. It is hypothesized that the low perceived severity of illness, coupled with the costs and inconvenience of care and the lack of physician enthusiasm for the treatment of mild hypertension leads to noncompliance with follow-up.Dr. Gillum is with the Laboratory of Physiological Hygiene and the Department of Medicine, Schools of Public Health and Medicine, University of Minnesota, Minneapolis, Minnesota. Dr. Neutra is with the Division of Epidemiology of the School of Public Health, University of California at Los Angeles. Dr. Stason is with the Center for the Analysis of Health Practices at the Harvard School of Public Health, Boston, Massachusetts. Dr. Solomon is with the Department of Medicine at Peter Bent Brigham Hospital, Boston, Massachusetts. Reprint requests should be addressed to Dr. Gillum, Laboratory of Physiological Hygiene, University of Minnesota, Stadium Gate 27, 611 Beacon St. SE, Minneapolis, Minnesota 55455. |
