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Randomized Controlled Trial
. 2022 Jan 1;40(1):189-193.
doi: 10.1097/HJH.0000000000003001.

Introducing the importance and difficulties of a three-step approach to improve nonadherence to antihypertensive drugs: a case series

Laura E J Peeters  1   2 , Jeroen B van der Net  3 , Kathy Schoenmakers-Buis  4 , Irene M van der Meer  4 , Emma K Massey  2 , Liset van Dijk  5 , Teun van Gelder  1   2 , Birgit C P Koch  2 , Jorie Versmissen  1   2
Affiliations
Randomized Controlled Trial

Introducing the importance and difficulties of a three-step approach to improve nonadherence to antihypertensive drugs: a case series

Laura E J Peeters et al. J Hypertens. .

Abstract

Nonadherence to antihypertensive drugs is an important reason for not reaching blood pressure goals. A possible method to improve nonadherence involves three essential steps: identification of nonadherent patients (step 1), determination of underlying causes (step 2) and a personalized solution (step 3). We present three unique cases to show the importance and difficulties of this three-step approach. Patients participated in a randomized controlled trial to improve nonadherence to antihypertensive drugs (RHYME-RCT, Dutch Trial Register NL6736). Drug level measurements were used to identify nonadherence to antihypertensive drugs and communication on drug levels was supported by a tailored feedback tool in these patients. These cases showed that a three-step approach of identifying nonadherence and determination of the underlying cause, can lead to a personalized solution to improve therapy even when nonadherence was excluded. Open communication with patients remains an essential part when improving nonadherence.

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Conflict of interest statement

L.E.J.P. received lecture fees from Astellas Pharma. The other authors declare that they have no financial relationships to the article and no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Communication tool to identify practical and perceptual barriers that underlie nonadherence to antihypertensive drugs.
See this image and copyright information in PMC

References

    1. Paul M, Barry RD, William CC, Sripal B, David AC, Sara LP, et al. Treatment-resistant hypertension and the incidence of cardiovascular disease and end-stage renal disease. Hypertension 2014; 64:1012–1021. - PubMed
    1. Zeller A, Taegtmeyer A, Martina B, Battegay E, Tschudi P. Physicians’ ability to predict patients’ adherence to antihypertensive medication in primary care. Hypertens Res 2008; 31:1765–1771. - PubMed
    1. Burnier M. Drug adherence in hypertension. Pharmacol Res 2017; 125:142–149. - PubMed
    1. van der Laan DM, Elders PJM, Boons C, Nijpels G, van Dijk L, Hugtenburg JG. Effectiveness of a patient-tailored, pharmacist-led intervention program to enhance adherence to antihypertensive medication: the CATI Study. Front Pharmacol 2018; 9:1057. - PMC - PubMed
    1. Peeters LEJ, Feyz L, Boersma E, Daemen J, van Gelder T, Koch BCP, Versmissen J. Clinical applicability of monitoring antihypertensive drug levels in blood. Hypertension 2020; 76:80–86. - PubMed

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