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

Aikaterini Kassavou, Venus Mirzaei, Sonia Shpendi, James Brimicombe, Jagmohan Chauhan, Debi Bhattacharya, Felix Naughton, Wendy Hardeman, 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 MantStephen 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 .

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

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