IMPACT OF HOME BLOOD PRESSURE MONITORING ON TREATMENT ADHERENCE IN PATIENTS WITH UNCONTROLLED HYPERTENSION

Objective: To evaluate the impact of Home Blood Pressure Monitoring (HBPM) on treatment adherence in hypertensive individuals taking medication, with uncontrolled blood pressure (BP).Design and method: Randomized controlled clinical trial conducted with individuals diagnosed with hypertension and uncontrolled BP (>140/90 mmHg), followed between December 2022 and September 2023 in a primary health care unit. Data collection occurred in five stages: 1) recruitment; 2) inclusion and collection of baseline data, including sociodemographic information and treatment adherence, measured by the 4-item Morisky-Green Scale; 3) randomization; 4) intervention, in which participants were divided into two groups: intervention (IG), who received a BP monitor for daily home measurements for 5 consecutive days each month, and control (CG), who did not perform HBPM. Both groups underwent three follow-up visits, where BP measurements were performed and, at the third visit, a new assessment of treatment adherence. The main outcome was the statistical difference in treatment adherence between the groups, comparing baseline with post-intervention data. The study was approved by a research ethics committee. Results: Seventy participants were randomized, with 43 completing the study. The sample was predominantly male, with incomplete elementary education and a mean age of 60.98 (±9.97) years. At baseline, the IG showed higher medication adherence compared to the CG (51.61% vs. 15.38%, p=0.002) and better intermediate adherence (45.16% vs. 71.79%, p=0.002). At the end of the study, the prevalence of high adherence to medication treatment was significantly higher in the IG (53.85%) compared to the CG (33.33%), with p=0.048. Conclusions: Although the IG already demonstrated a higher adherence rate at baseline, HBPM contributed to an additional improvement in adherence to medication treatment. These results indicate that HBPM may be an effective strategy to improve treatment adherence in primary health care.