Abstract

Objetive: To evaluate the effect of a provider’s psychosocial- skills training to promote hypertension medication adherence. The intervention was based on patient-centered approaches and Leventhals commonsense model of self-regulation. Methods: Five Primary Health Care Centers from middle-low income neighbourhoods were randomly assigned to the Inter- vention (IG) or Control Group (CG). All participating providers (N=22) received a 4-hour biomedical training to discuss High Blood Pressure Guidelines. The IG additionally received an 8-hour psychosocial training. Eligible patients were in pharma- cological treatment for hypertension and had blood pressure measures over 140/90 mm Hg in 2 consecutive medical visits. Main outcomes are follow-up blood pressure and adherence to prescribed antihypertensive medication (Morisky questionnaire and MEMs electronic monitoring system). Results: We are reporting data from a sample of 77 patients (IG= 37; CG= 40). The number of patients complying with medi- cation at follow up is higher in the experimental than in the con- trol group (Kendall’s tau =0.212; p<0.02). Medication adherence is predicted by the intervention, after adjusting for demograph- ics and base-line adherence (Exp(B)= 0,224; p<0,03). Systolic and diastolic blood pressure decreased in experimental patients from 156.46 to 141.6 (t=4.47; p<0.0001) and from 92.l7 to 85.35 mmHg (t= 3.40; p<0.002), respectively. However, a multivariate regression analysis adjusted for demographics and blood pres- sure at base-line is not statistically signi cant (β=0.198; p<0.08). Systolic blood pressure also decreased in control group patients. Conclusion: Patients medication adherence is modi able by a brief training to the health providers probably modifying the patient-provider interaction during the medical visit.