Elliott WJ
Influence of socioeconomic factors in maintaining enrollment in a tertiary hypertension clinic
11th Scientific Meeting, American Society of Hypertension
Am J Hypert (Apr) 9:170A 1996

Regardless of what medicine is used to treat hypertension, it won't be effective if not taken. A common idea is, that poor, poorly educated patients, are less compliant than their more well-to-do, educated counterparts.

Elliott studied this question at a medical center where the patient mix is quite varied. 2800 patients were studied who attended a hypertension clinic. Over a 7 year period, there were 1200 patients who for various seemingly inappropriate reasons, failed to return to clinic after 3 consecutive telephone calls and letters. Dropouts vs. non dropouts were compared. Age, race, gender, education level, and presence/absence of private insurance, in fact, nothing, was able to separate dropouts from non-dropouts. The results suggest that more work needs to be done to address this problem.

Comment: The weakness of this study is, that no follow-up was done to document that the 40% of patients who "dropped out" actually did so, although considerable effort was made to exclude patients who went to other physicians, moved out of the area, etc. It seems that non-compliance is a human trait that is present widely in many socioeconomic groups. This appears to be a very fruitful area for further investigation. (John T. Daugirdas, M.D., University of Illinois at Chicago)

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11th Scientific Meeting, American Society of Hypertension
H: Drug therapy : Compliance