Validación de la llamada telefónica como método de medida del cumplimiento terapéutico de la hipertensión arterial en Extremadura / Validation of the telephone call as a method for measuring compliance to arterial hypertension treatment in Extremadura

Introducción. El incumplimiento farmacológico supone un importante problema que afecta el éxito terapéutico de los pacientes. El objetivo principal de esta investigación consistió en validar la llamada telefónica al domicilio del paciente como método de automedición del recuento de comprimidos simple como método alternativo al patrón oro del recuento simple en consulta sanitaria. Pacientes y métodos. Estudio de investigación observacional, multicéntrico, prospectivo, longitudinal, desarrollado por 25 investigadores en diferentes centros de salud de Extremadura que incluyeron 125 pacientes diagnosticados de hipertensión arterial no controlada de los cuales finalizaron 121. La inclusión de pacientes se realizó de forma consecutiva y a medida que el investigador detectaba un hipertenso no controlado. Se efectuaron 3 visitas, que incluían visita de inclusión, visita de seguimiento a las 4 semanas y visita final a las 8 semanas. Previamente a las visitas primera y final, se realizó la llamada telefónica al paciente para recordarle la visita correspondiente y recopilar en ese mismo momento información sobre el número de comprimidos que le quedaban. Resultados. Fueron incluidos 121 pacientes. En la visita final, el test de la llamada telefónica como método de medida del cumplimiento obtuvo: sensibilidad: 100%; especificidad: 86%; exactitud global: 86,8%; VPP: 30,4%; VPN: 100%; CP+: 7,13; CP−: 0,0 e índice kappa: 0,415 (p < 0,0001). El área bajo la curva ROC fue de 0,995 (IC95%: 0,985-1). Conclusiones. Concluimos que la llamada telefónica como método de medida del cumplimiento terapéutico puede ser una buena alternativa por su casi universalidad, coste reducido y sin la necesidad de desplazamiento de los pacientes a los centros sanitarios (AU)

Introduction. Pharmacological non-compliance is a significant problem that can affect patient health. The main aim of this investigation is to validate the telephone call to the patient’ home as a self-report method of counting the amount of tablets taken by the patient, as an alternative method to a simple tablet count in the clinic (gold standard). Patients and methods. An observational, multicentre, prospective, and longitudinal study was conducted by 25 researchers in different health centres in Extremadura, and which included 125 consecutively enrolled patients with uncontrolled arterial hypertension, 121 ended the study. Three visits were made, including enrollment visit, follow-up visit at 4 weeks, and final visit at 8 weeks. A telephone call was made prior to the enrollment and final visit to remind the patients of the next visit, and to ask at the same time about the number of tablets remaining. Results. A total of 121 patients completed the study. In the final visit, the phone-call method of compliance showed: 100% sensitivity, 86% specificity, 86.8% of overall accuracy, 30.4% PPV, 100% NPV, CP+ 7.13, CP− 0.0, and a kappa index of 0.415 (P < .0001). The area under the ROC curve was 0.995 (95% CI, 0.985-1). Conclusions. It was concluded that the telephone phone call, as a therapeutic compliance method, can be a good alternative due to being almost universal, easy to use, its reduced cost, and without the need of patients to go to the medical centres (AU)

[Validation of the telephone call as a method for measuring compliance to arterial hypertension treatment in Extremadura]. / Validación de la llamada telefónica como método de medida del cumplimiento terapéutico de la hipertensión arterial en Extremadura.

INTRODUCTION: Pharmacological non-compliance is a significant problem that can affect patient health. The main aim of this investigation is to validate the telephone call to the patient' home as a self-report method of counting the amount of tablets taken by the patient, as an alternative method to a simple tablet count in the clinic (gold standard). PATIENTS AND METHODS: An observational, multicentre, prospective, and longitudinal study was conducted by 25 researchers in different health centres in Extremadura, and which included 125 consecutively enrolled patients with uncontrolled arterial hypertension, 121 ended the study. Three visits were made, including enrollment visit, follow-up visit at 4 weeks, and final visit at 8 weeks. A telephone call was made prior to the enrollment and final visit to remind the patients of the next visit, and to ask at the same time about the number of tablets remaining. RESULTS: A total of 121 patients completed the study. In the final visit, the phone-call method of compliance showed: 100% sensitivity, 86% specificity, 86.8% of overall accuracy, 30.4% PPV, 100% NPV, CP+ 7.13, CP- 0.0, and a kappa index of 0.415 (P<.0001). The area under the ROC curve was 0.995 (95% CI, 0.985-1). CONCLUSIONS: It was concluded that the telephone phone call, as a therapeutic compliance method, can be a good alternative due to being almost universal, easy to use, its reduced cost, and without the need of patients to go to the medical centres.

[Acetylation polymorphism in lung cancer]. / Polimorfismo acetilador en el cáncer de pulmón.

The acetylation phenotype was determined, by means of sulfamethazine measurement, in 87 patients (83 male) with confirmed bronchogenic carcinoma and in 93 healthy control patients (41 male) of equal ages. 48 patients and 54 controls were classified as being "slow acetylators" (Ch2 n.s.) When the persons were individually analysed by phenotype, it was confirmed that the patients showed a significantly lower rate of acetylated sulfamethazine than the control group (p less than 0.02), owing to the poor acetylation of patients with small-cell lung cancer. This difference should be confirmed by more detailed pharmacokinetic studies before regarding it as a possible interference of paraneoplasic type. The polymorphism acetylator cannot be considered a genetic marker related to the risk of having lung cancer.