Scientific Reports (Apr 2021)

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 Mant,
  • Stephen Sutton

DOI
https://doi.org/10.1038/s41598-021-88170-2
Journal volume & issue
Vol. 11, no. 1
pp. 1 – 11

Abstract

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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 .