The availability of a home tonometer as a factor that increases therapy compliance in outpatients with arterial hypertension

The use of technical means, home automatic tonometers in particular, is one of the possible ways of enhancing therapy compliance. Aim: to evaluate the impact of the availability of an automatic tonometer on patient adherence to antihypertensive therapy and its efficiency. Subjects and methods. The investigation included 60 patients aged 45–75 years with grades 1–2 arterial hypertension. The patients were randomized to tonometer Group «OMRON» that was given an OMRON automatic tonometer and control Group that was not given the latter. Compliance-increasing methods, such as giving losartan free of charge, a self-control diary, and written recommendations, were used in all the study participants. General clinical examination, office blood pressure (BP) measurement, biochemical blood testing, and questioning using the hospital anxiety and depression scale (HADS), Morisky-Green test, and a visual analogue scale (VAS) were employed to assess quality of life. Results. Both groups achieved a reduction in systolic and diastolic blood pressures (SBP and DBP). The quality of life was improved only in Group «OMRON» (VAS scores increased from 64,8 to 73,6; p=0,01). At visit 1 (at week 3), the patients in both groups showed an equally high level of compliance. At visit 2 (at week 12) the compliance in Group «OMRON» increased up to 96,4% whereas that in Group «Control» decreased to 81,3% (a 15,1% difference; p<0,001). There was a positive correlation between the degree of a change in quality of life (VAS) and compliance (r=0,37; p=0,02). Subgroup 3 included the patients who had not got an automatic tonometer before the investigation (16 and 10 patients from Groups «OMRON» and «Control», respectively). In the subgroup, SBP lowering was achieved only in the participants from Group «OMRON» at visit 2. The degree of DBP reductions was also greater in Group «OMRON» (∆DBP, 9,6 versus 6,6 mm Hg; р=0,05). Conclusion. The availability of an automatic tonometer enhances adherence to antihypertensive therapy in the patients and it is associated with their better quality of life. In the patients who had not got an automatic tonometer before the investigation, its giving increased the efficiency of antihypertensive therapy.