REFERENCE: Geary, D.C., Hovell, M.F. (1985). Behavioral and medical monitoring for hypertension control: A counselor feedback and consulting model. Patient Education and Counseling, 7, 77-85.

A medical management system designed to track both the biophysical (e.g. blood pressure) and behavioral (e.g. adherence) concommitants of pharmacological treatment was used for a subsample of uncontrolled hypertensive patients. Patient blood pressure and concurrent adherence levels were monitored by health promotion research assistants for possible over- or undermedication. For 20% of the monitored patients a change in the medical regimen seemed necessary. Health promotion professionals consulted with physicians regarding possible difficulties with the medication regimen. Physicians were highly responsive to the consultation, and in all cases re-evaluated the patients' treatment regimen. In most cases prescriptions were changed and blood pressure decreased. Adherence was not adversely affected, despite prescription changes. Physician responsiveness to the implementation of these medical management procedures and to consultations regarding potential inadequacies in the medical regimen suggest this model may be a useful adjunct to the usual pharmacological treatment of hypertension or other chronic disease.


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