Directly Observed Therapy in Hypertension (DOT-HTN)

Hjørnholm, Ulla; Aamodt, Mikaela; Larstorp, Anne Cecilie K.; Elmula, Fadl Elmula M. Fadl; Høieggen, Aud; Andersen, Marit Helen; Kjeldsen, Sverre E.

doi:10.1007/978-3-319-76593-8_6

Cited by 5 publications

(3 citation statements)

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“…A commonly used method is witnessed intake of drugs or “directly observed treatment” that guarantees same-day adherence, but does not give any insight into the persistence of this behavior. 88 Tele-monitoring [or “digital medicines”] is based on the ability to detect a small electronic device incorporated inside the drug in question that is activated when the drug is dissolved in the digestive system and detected by a noninvasive device. 89 Though not routinely used in the context of treating hypertension, such telemedicine has been used in certain tuberculosis- and psychiatric treatment regimens.…”

Section: Assessment Of Nonadherencementioning

confidence: 99%

Medical Measures in Hypertensives Considered Resistant

Fadl Elmula,

Mariampillai,

Heimark

et al. 2023

American Journal of Hypertension

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BACKGROUND Patients with resistant hypertension is the group of hypertensive patients with the highest cardiovascular risk. METHODS All rules and guidelines for treatment of hypertension should be followed strictly to obtain blood pressure control in resistant hypertension. The mainstay of treatment of hypertension, also for resistant hypertension, is pharmacological treatment, which should be tailored to each patient’s specific phenotype. Therefore, it is pivotal to assess non-adherence to pharmacological treatment as this remains the most challenging problem to investigate and manage in the setting of resistant hypertension. RESULTS Once adherence has been confirmed, patients must be thoroughly worked-up for secondary causes of hypertension. Until such possible specific causes have been clarified, the diagnosis is apparent treatment resistant hypertension. Surprisingly few patients remain with true treatment resistant hypertension when the various secondary causes and adherence problems have been detected and resolved. Refractory hypertension is a term used to characterize the treatment resistance in hypertensive patients in patients ≥5 antihypertensive drugs. All pressor mechanisms may then need blockage before their blood pressures are reasonably controlled. CONCLUSIONS Patients with resistant hypertension need careful and sustained follow-up and review of their medications and dosages at each term since medication adherence is a very dynamic process.

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Section: Assessment Of Nonadherencementioning

confidence: 99%

Medical Measures in Hypertensives Considered Resistant

Fadl Elmula,

Mariampillai,

Heimark

et al. 2023

American Journal of Hypertension

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“…Непосредственное наблюдение за приемом АГП, снижающих АД (обычно с последующим мониторингом АД), является одним из наиболее эффективных методов по оценке уровня приверженности [11,91]. При данном подходе АГТ принимается пациентом под наблюдением медицинского персонала ежедневно в течение определенного периода, как правило, во время госпитализации в стационаре, что гарантирует 100% вероятность приема терапии [75].…”

Section: менее точный более точный точностьunclassified

“…Во-первых, он не оценивает уровень приверженности к АГТ с течением времени. Во-вторых, имеются данные о возникновении эпизодов гипотонии в первые дни приема [91,92].…”

Section: менее точный более точный точностьunclassified

Russian Medical Society for Arterial Hypertension expert consensus. Arterial hypertension and adherence to antihypertensive therapy

Chazova,

Solntseva,

Sivakova

et al. 2024

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Despite the existing recommendations for the diagnosis and treatment of arterial hypertension, a wide selection of antihypertensive drugs, the efficacy of treatment of arterial hypertension remains low. The main cause for unsatisfactory control of arterial hypertension is patients’ non-adherence to treatment, which adversely affects the prognosis for cardiovascular complications. The first step in increasing adherence to antihypertensive therapy is to determine its level. There are various methods characterized by their accessibility and accuracy for assessing adherence. There are several categories of factors influencing the level of adherence. Identifying the cause in a subsequent patient is a significant step in reducing adherence to antihypertensive therapy. In addition, it’s necessary to use strategies to increase adherence to antihypertensive therapy, including both “simplification” of the treatment regimen and strengthening the doctor-patient interaction. The aim of this consensus is to summarize and supplement knowledge about the prevalence of adherence to antihypertensive therapy in patients with arterial hypertension, methods for assessing the level of adherence, the reasons for low adherence to the treatment of arterial hypertension and approaches to improving adherence to antihypertensive medications.

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