Journal of General Internal Medicine

, Volume 2, Issue 5, pp 298–305 | Cite as

The effect of medication compliance on the control of hypertension

  • Seth A. Eisen
  • Robert S. Woodward
  • Douglas Miller
  • Edward Spitznagel
  • Cynthia A. Windham
Original Articles


The effect of medication-taking patterns on blood pressure was investigated in 24 hypertensive outpatients being treated with once-daily doses of hydrochlorothiazide or chlorthalidone. Medication-taking patterns were measured with a small pill dispenser that electronically records the time of medication removal. Blood pressure reduction was found to correlate better with the total number of doses the patient removed from the pill pack during a month than with any of four other compliance measures that were based on the timing of dose removal. Analysis also suggested that blood pressure is improved if patients ingest omitted doses to “catch up” to the prescribed regimen. It is concluded that a simple pill count may be the most clinically relevant definition of compliance for patients with hypertension being treated with only hydrochlorothiazide or chlorthalidone, and that such patients should ingest all prescribed doses, regardless of the time interval between doses.

Key words

medication compliance hypertension hydrochlorothiazide chlorthalidone 


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Copyright information

© Society of General Internal Medicine 1987

Authors and Affiliations

  • Seth A. Eisen
    • 1
    • 2
  • Robert S. Woodward
    • 3
  • Douglas Miller
    • 4
  • Edward Spitznagel
    • 5
  • Cynthia A. Windham
    • 6
  1. 1.Health Services Reserach and Development ServiceSt. Louis Veterans Administration Medical CenterUSA
  2. 2.the Department of MedicineWashington University School of MedicineSt. Louis
  3. 3.Health Administration ProgramWashington University School of MedicineUSA
  4. 4.Department of MedicineSt. Louis University School of MedicineSt. Louis
  5. 5.Department of Preventive Medicine and Public Health, Division of BiostatisticsWashington University School of MedicineUSA
  6. 6.Department of PsychiatryWashington University School of MedicineUSA

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