Experimental analysis of adherence counseling: implications for hypertension management |
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| Authors: | M F Hovell D C Geary D R Black K Kamachi R Kirk J Elder |
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| Affiliation: | 1. Division of Health Promotion, Graduate School of Public Health, San Diego State University, San Diego, California, 92182 USA;2. Department of Psychology, University of California, Riverside, California, 92502 USA;3. Center for Health Promotion, Purdue University, West Lafayette, Indiana, 47907 USA;4. Northwestern University School of Medicine, 303 East Chicago Avenue, Chicago, Illinois, 60201 USA;6. High Blood Pressure Clinic, Internal Medicine, Kaiser Permanente Hospital, Hayward, California 94545 USA |
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| Abstract: | A time series "reversal" design demonstrated that behavioral counseling increased medication adherence from about 60 to 100% for a black, hypertensive patient. However, inadequate pharmacological treatment yielded no clinically important blood pressure decrease. The combination of improved compliance and minimal blood pressure reduction led the patient's physician to explore higher doses and alternate medications to achieve blood pressure control. The physician's aggressive medical treatment was initiated only after the patient's compliance had been improved. Thus, this study suggests that paraprofessional counseling can increase compliance and illustrates the need for both behavioral and physiological data in clinical management to avoid blaming patients for poorly controlled blood pressure. |
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| Keywords: | To whom reprint requests should be addressed. |
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