BMJ  2004;328:204 (24 January), doi:10.1136/bmj.37967.374063.EE (published 15 January 2004)

Primary care

Randomised equivalence trial comparing three month and six month follow up of patients with hypertension by family practitioners

Richard V Birtwhistle, professor of family medicine1, Marshall S Godwin, professor of family medicine1, M Dianne Delva, associate professor of family medicine1, R Ian Casson, assistant professor of family medicine1, Miu Lam, associate professor of community health and epidemiology2, Susan E MacDonald, assistant professor of family medicine1, Rachelle Seguin, research associate1, Lucia Rühland, research associate1, Hypertension Follow-up Study Group

1 Centre for Studies in Primary Care, Queen's University, PO Bag 8888, Kingston, ON, Canada K7L 5E9, 2 Department of Community Health and Epidemiology, Queen's University, Kingston, ON, Canada K7L 3N6

Correspondence to: R Birtwhistle birtwhis{at}post.queensu.ca

Objective To compare blood pressure control, satisfaction, and adherence to drug treatment in patients with treated hypertension followed up by their family physicians either every three months or every six months for three years.

Design Randomised equivalence clinical trial.

Settings 50 family practices in south eastern Ontario, Canada.

Participants 609 patients aged 30-74 years with essential hypertension receiving drug treatment whose hypertension had been controlled for at least three months before entry into the study.

Results 302 patients were randomly assigned to follow up every three months and 307 to follow up every six months. Baseline variables in the two groups were similar. As expected, patients in the six month group had significantly fewer visits, but patients in both groups visited their doctor more frequently than their assigned interval. Mean blood pressure was similar in the groups, as was control of hypertension. Patient satisfaction and adherence to treatment were similar in the groups. About 20% of patients in each group had blood pressures that were out of control during the study.

Conclusions Follow up of patients with treated essential hypertension every six months is equivalent to follow up every three months. Patient satisfaction and adherence to treatment are the same for these follow up intervals. As about 20% of patients' hypertension was out of control at any time during the study in both groups, the frequency of follow up may not the most important factor in the control of patients' hypertension by family practitioners.


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Rapid Responses:

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Something better could exist
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