Therapeutic drug monitoring‐guided definition of adherence profiles in resistant hypertension and identification of predictors of poor adherence

Avataneo, Valeria; Nicolò, Amedeo De; Rabbia, Franco; Perlo, E.; Burrello, Jacopo; Berra, E.; Pappaccogli, Marco; Cusato, Jessica; D’Avolio, Antonio; Perri, Giovanni Di; Veglio, Franco

doi:10.1111/bcp.13706

Cited by 39 publications

(37 citation statements)

References 36 publications

(42 reference statements)

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“…Generally, it refers to medication or drug adherence (Jimmy & Jose, 2011). Poor adherence to medication is common in individuals with hypertension (Avataneo et al, 2018) particularly among the elderly in Lo, Chau, Woo, Thompson, and Choi (2016). Adherence was related to better health outcomes such as quality of life (Park, Song, Shin, Jeong, & Lee, 2018).…”

Section: Introductionmentioning

confidence: 99%

Improved adherence in older patients with hypertension: An observational study of a community‐based intervention

Tankumpuan

Anuruang

Jackson³

et al. 2019

Int J Older People Nursing

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Aims and objectives This study sought to assess the effect of a community‐based intervention influencing adherence status at baseline, 1, 3 and 6 months, and to evaluate the impact that a community‐based intervention and socio‐economic factors have on adherence. Background Although high‐quality treatment and modern hypertension clinical practice guidelines have been developed worldwide, the outcomes of patients with hypertension in Thailand are not optimal. Implementing a person‐centred and integrated health services model to improve hypertension management, such as a community‐based intervention, is challenging for healthcare providers in Thailand. Design An observational study of a community‐based intervention. Methods The study comprised residents in 17 villages in one province of Thailand. A sample of 156 participants was allocated into the intervention and the control groups. Inclusion criteria were people aged 60 years or older diagnosed with hypertension. Exclusion criteria included the latest record of extreme hypertension and having a documented history of cognitive impairment. The intervention group received the 4‐week community‐based intervention programme. Multiple linear regression was applied to predict the adherence status at each phase. Multiple logistic regression was then implemented to predict influencing factors between the groups. Results Patients who received the intervention had significantly lower adherence scores (reflecting a higher level of adherence) at 3 and 6 months after intervention by 1.66 and 1.45 times, respectively, when adjusting for other variables. After 6 months, the intervention was associated with a significant improvement in adherence when adjusting for other variables. Conclusion This study provides evidence to support the use of community‐based interventions as an effective adjunct to hospital‐based care of hypertension patients in Thailand. Implications for practice Understanding factors between health outcomes and social determinants of health is crucial for informing the development of culturally appropriate interventions.

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Section: Introductionmentioning

confidence: 99%

Improved adherence in older patients with hypertension: An observational study of a community‐based intervention

Tankumpuan

Anuruang

Jackson³

et al. 2019

Int J Older People Nursing

View full text Add to dashboard Cite

show abstract

“…This, together with undisclosed suboptimal implementation or complete discontinuation, is recognised increasingly as contributing to apparent resistance to antihypertensive treatment. Using liquid chromatography tandem mass spectrometry to quantify a wide panel of antihypertensive drugs in plasma, Avataneo et al found that 18% of seemingly treatment‐resistant patients had undetectable concentrations of all their prescribed drugs. A similar proportion was reported by de Jager et al who found 16% of patients to be completely non‐adherent, with a further 52% of patients implementing suboptimally.…”

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confidence: 99%

Medication adherence—Key considerations for clinical pharmacologists

Hughes

2020

Brit J Clinical Pharma

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“…Increased HR is an independent risk factor for cardiovascular events and mortality in the general population and various cardiovascular pathologies. High HR was recently shown to be associated with a poor adherence to medication regimens in patients with resistant hypertension . There are only a few prospective studies regarding the effect of HR reduction in heart failure and coronary artery disease.…”

mentioning

confidence: 99%

Chronotherapy as a potential approach to hypertensive patients with elevated heart rate?

Šimko

Baka

2019

Brit J Clinical Pharma

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Therapeutic drug monitoring‐guided definition of adherence profiles in resistant hypertension and identification of predictors of poor adherence

Abstract: This evidence highlights the high prevalence of poor adherence in patients with resistant hypertension and the need for caution in using invasive approaches. These preliminary data require validation in a larger cohort, to confirm the need for TDM in routine clinical practice.

Cited by 39 publications

References 36 publications

Improved adherence in older patients with hypertension: An observational study of a community‐based intervention

Improved adherence in older patients with hypertension: An observational study of a community‐based intervention

Medication adherence—Key considerations for clinical pharmacologists

Chronotherapy as a potential approach to hypertensive patients with elevated heart rate?

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