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Aten Primaria. 2011 Jul;43(7):336-42. doi: 10.1016/j.aprim.2010.04.018. Epub 2011 Feb 20.

[A prescription register incorporated into computerized medical records for patients with hypertension: a new instrument to evaluate medication adherence].

[Article in Spanish]

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Centro de Salud La Marina, SAP, Esquerra de Barcelona, Institut Català de la Salut Barcelona, Spain.



To study the validity of a prescription register (PR) incorporated into computerized medical records (CMR) compared with the Morisky-Green test in patients with high blood pressure using anti-hypertensive medication.


Cross-sectional study.


Primary Care.


A total of 252 patients with hypertension using drug therapy with no changes in drugs or dosage were randomly selected.


Descriptive variables, blood pressure, proportion of drug therapy collected from pharmacies according to the PR over 12 months compared with drug therapy prescribed in CMR (poor medication adherence [MA] if <80%), and Morisky-Green test. Validity of the PR was analysed using the Kappa index to compare PR with the Morisky-Green test (reference) and blood pressure levels.


Mean age was 68 years, 50% were women, and 77% completed the study. Poor MA was 51.3% according to the PR (95% CI 44.3%-58.3%) and 15.4% (95% CI; 10.3%-20.4%) when using the Morisky-Green test. The Kappa index was -0.068. Patients with poor MA according to the PR had higher levels of systolic and diastolic blood pressure (4.3 and 2.9 mmHg, respectively, P<0.05). No differences in blood pressure were observed in patients with poor MA if the Morisky-Green test was used (0.1 and 1 mmHg, respectively, P>0.05).


Poor MA according to the PR is high and is associated with poorer control of blood pressure; the Morisky-Green test does not pick up on these differences. These results suggest that the PR could be useful for evaluating MA and that the Morisky-Green test underestimates poor MA.

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