[Assessment of antihypertensive compliance using a self-administered questionnaire: development and use in a hypertension clinic]. / Evaluation de l'observance du traitement antihypertenseur par un questionnaire: mise au point et utilisation dans un service spécialisé.

OBJECTIVE: The most practical method of assessing medication compliance is to ask the patient for a self-report; but the interview question has to be selected and validated. The aim of this work was to select and validate interview questions to be used in a self-administered questionnaire for measurement of medication compliance in hypertensive patients. PATIENTS AND METHODS: In 117 treated hypertensive patients, we compared an interview question to a clinical evaluation of medication compliance. Kappa indices were calculated to test the concordance between interview question and medication compliance. In 184 patients treated for hypertension since at least a year, the validated self-report was compared to a clinical evaluation of medication compliance. RESULTS: Interview questions were not equally sensitive for detection of medication compliance and 6 questions were included in the Compliance Evaluation Test (CET). In 184 patients, we compared the results obtained with CET to clinical evaluation of medication compliance. Values of kappa indices were above 0.5 in "good compliance" when "No" was answered to the 6 items, in "minor noncompliance" when 1 or 2 "Yes" were given, in "noncompliance" when 3 or more "Yes" were given. In this population of hypertensive patients followed in a hypertension clinic, we observed 10% "noncompliance", 24% "minor noncompliance", and 66% "good compliance". CONCLUSION: In clinical practice, interview may be the most useful method of measuring medication compliance. We demonstrated that the compliance evaluation test is validated and may help physicians to face the problem of nonadherence among their hypertensive patients.

[Comparative study of the BACTEC 9000 MB system and Lowenstein Jensen media for mycobacterial culture]. / Etude comparative du système BACTEC 9000 MIB et du milieu de Lowenstein Jensen pour la culture des mycobactéries.

An automated system for mycobacteria culture, BACTEC 9000 MB, was compared with Lowenstein Jensen culture. On a total of 4,484 pulmonary and extrapulmonary human clinical samples, 126 (2.8%) were positive for mycobacteria on Lowenstein Jensen (LJ) medium; 105 (2.34%) were identified as Mycobacterium tuberculosis and 39 (1.10%) as non tuberculosis mycobacteria. The mean time of detection of Mycobacterium tuberculosis on the 131 positive samples was reduced to approximately ten days with BACTEC 9000 MB compared to the LJ (17.6 versus 27.38 days). Through the results of this comparative study, we confirmed that BACTEC 9000 MB is a more efficient system than LJ for culture detection of all mycobacteria from various sites samples.