Automated telephone call reminders helped people with high blood pressure to lower their readings compared with people who did not receive the calls, researchers in Montreal found.

In the one-year study to be published in the journal Circulation: Cardiovascular Quality and Outcomes, 223 patients with hypertension were randomly assigned to receive calls from a computer-based system at least once a week with high readings sent to their doctors or receive an educational booklet and usual medical care.

"Forty-six per cent were controlled, achieved the target, versus 28 per cent without the system," senior author Dr. Pavel Hamet, a professor of medicine, physiology and nutrition at the University of Montreal, said Tuesday.

The improvement was "highly significant," and the system worked as well as adding a new medication, Hamet said.

Patients were recruited through general practitioners in Laval.

The 111 participants in the reminder or intervention group received phone calls from once a day to several times a week depending on a pre-determined schedule.

An automated voice would ask about blood pressure readings from a digital home blood pressure monitor and log book that were provided and if medications were taken — information that was relayed to the patients' physicians and pharmacists.

If a blood pressure reading was very high, a doctor would be notified immediately, Hamet said.

Regular feedback key

Pharmacists and study participants were told if prescriptions were not refilled in time.

If patients had not taken readings or medications, they were asked to do so and the system would call them back.

Physicians treating those in the intervention group were more likely to add drugs or increase dosages, the researchers found. By the end of the study, those in the reminder group were taking an average of two classes of antihypertensive drugs compared to one for the control group.

Since patients may not experience any symptoms from hypertension, they may forget to take their medications.

Hamel attributed the success of the program to the regular feedback that patients received. A friendly reminder, even if it was an automated voice, helped.

The study shows the program is useful, but it remains to be seen whether the automated system would be cost-effective in the real world, said Dr. Frans Leenen, director of the hypertension unit at the University of Ottawa Heart Institute, who was not involved in the study.

Hamel's team is designing another study to assess the costs of the program in terms of the automated system, extra medications and home monitors versus the benefits of preventing strokes or kidney damage — costly complications of hypertension.

With files from The Canadian Press