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Non-adherence to antihypertensive medications is related to pill burden in apparent treatment resistant hypertensive individuals
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Lawson, Alexander J., Hameed, Mohammed Awais, Brown, Roger, Cappuccio, Francesco, George, Stephen, Hinton, Thomas, Kapil, Vikas, Lenart, Jane, Lobo, Melvin D., Martin, Una, Menon, Madhavan, Nightingale, Angus, Rylance, Paul B., Webb, David J. and Dasgupta, Indranil (2020) Non-adherence to antihypertensive medications is related to pill burden in apparent treatment resistant hypertensive individuals. Journal of Hypertension, 38 (6). pp. 1165-1173. doi:10.1097/HJH.0000000000002398
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WRAP-non-adherence-antihypertensive-medications-pill-Cappuccio-2020.pdf - Accepted Version - Requires a PDF viewer. Download (721Kb) | Preview |
Official URL: http://dx.doi.org/10.1097/HJH.0000000000002398
Abstract
Objective: Non-adherence to medication is present in ≥50% of patients with apparent treatment resistant hypertension. We examined the factors associated with non-adherence as detected by an LC-MS/MS based urine antihypertensive drug assay.
Methods: All urine antihypertensive test results, carried out for uncontrolled hypertension (BP persistently >140/90 mmHg) between January 2015 and December 2016 at a single toxicology laboratory were analysed. Drugs detected were compared to the antihypertensive drugs prescribed. Patients were classified as adherent (all drugs detected), partially non-adherent (≥1 prescribed drugs detected) or completely non-adherent (no drugs detected). Demographic and clinical parameters were compared between the adherent and non-adherent groups. Binary logistic regression analysis was performed to determine association between non-adherence and demographic and clinical factors.
Results: Data on 300 patients from 9 hypertension centres across the UK were analysed. The median age was 59 years, 47% female, 71% Caucasian , median clinic BP was 176/95 mmHg and the median number of antihypertensive drugs prescribed was four. One hundred and sixty-six (55%) were non-adherent to prescribed medication with 20% of these being completely non-adherent. Non-adherence to antihypertensive medication was independently associated with younger age, female gender, number of antihypertensive drugs prescribed, total number of all medications prescribed (total pill burden) and prescription of a calcium channel blocker.
Conclusion: This LC-MS/MS urine analysis-based study suggests the majority of patients with apparent treatment resistant hypertension are non-adherent to prescribed treatment. Factors that are associated with non-adherence, particularly pill burden, should be taken into account while treating these patients.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RM Therapeutics. Pharmacology | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Journal of Hypertension | ||||||||
| Publisher: | Lippincott Williams & Wilkins, Ltd. | ||||||||
| ISSN: | 0263-6352 | ||||||||
| Official Date: | June 2020 | ||||||||
| Dates: |
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| Volume: | 38 | ||||||||
| Number: | 6 | ||||||||
| Page Range: | pp. 1165-1173 | ||||||||
| DOI: | 10.1097/HJH.0000000000002398 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Reuse Statement (publisher, data, author rights): | This is a non-final version of an article published in final form in Lawson, Alexander J., Hameed, Mohammed Awais, Brown, Roger, Cappuccio, Francesco, George, Stephen, Hinton, Thomas, Kapil, Vikas, Lenart, Jane, Lobo, Melvin D., Martin, Una, Menon, Madhavan, Nightingale, Angus, Rylance, Paul B., Webb, David J. and Dasgupta, Indranil (2020) Non-adherence to antihypertensive medications is related to pill burden in apparent treatment resistant hypertensive individuals. Journal of Hypertension. doi:10.1097/HJH.0000000000002398 | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
| Copyright Holders: | Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. | ||||||||
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