Validation of the electronic prescription as a method for measuring treatment adherence in hypertension
Por:
Márquez-Contreras E, López García-Ramos L, Martell-Claros N, Gil-Guillen VF, Márquez-Rivero S, Pérez-López E, Garrido-Lopez MA, Farauste C, López-Pineda A, Casado-Martinez JJ, Orozco-Beltran D, Quesada JA and Carratalá-Munuera C
Publicada:
1 sep 2018
Ahead of Print:
23 abr 2018
Categoría:
Medicine (miscellaneous)
Resumen:
Objective: To validate electronic prescriptions (e-prescriptions) as a method for measuring treatment adherence in patients with hypertension.
Methods: This prospective study initially included 120 patients treated for hypertension in primary care centers. Adherence was measured using the gold standard, the medication event monitoring system (MEMS), versus the index test, the e-prescription program, at baseline and at 6,12,18 and 24 months. We calculated the adherence rate using the MEMS and the medication possession ratio (MPR) for the e-prescriptions. We considered patients adherent if they had an adherence rate of 80% to 100%. To validate the e-prescription, we obtained measures of diagnostic accuracy, the Kappa concordance index, and the area under the ROC curve (AUC).
Results: We included 102 patients. Overall adherence was 77.4% by MEMS (95%CI: 66.8-88) and 80.4% (95%CI: 70.3-90.5) by MPR. At 24 months, sensitivity was 87% and specificity, 93.7%. The AUC was 0.903 (95%CI: 0.817-0.989).
Conclusion: Measures of treatment adherence were not significantly different between e-prescription and gold standard at most visits, and the e-prescription showed good discriminatory diagnostic capacity. Practice implications: If patients are included in an e-prescription program for at least 2 years, e- prescription is an inexpensive method to measure adherence in hypertension. (C) 2018 Elsevier B.V. All rights reserved.
Filiaciones:
Márquez-Contreras E:
La Orden Clinical Management Unit, Huelva, Spain
López García-Ramos L:
Adoratrices Clinical Management Unit, Huelva, Spain
Martell-Claros N:
Internal Medicine Department, San Carlos Hospital, Madrid, Spain
:
Cátedra de Medicina de Familia. Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain
Márquez-Rivero S:
La Orden Clinical Management Unit, Huelva, Spain
Pérez-López E:
La Orden Clinical Management Unit, Huelva, Spain
Garrido-Lopez MA:
La Orden Clinical Management Unit, Huelva, Spain
Farauste C:
La Orden Clinical Management Unit, Huelva, Spain
López-Pineda A:
Cátedra de Medicina de Familia. Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain
Casado-Martinez JJ:
La Orden Clinical Management Unit, Huelva, Spain
:
Cátedra de Medicina de Familia. Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain
Quesada JA:
Cátedra de Medicina de Familia. Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain
Carratalá-Munuera C:
Cátedra de Medicina de Familia. Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain
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