Patients with uncontrolled hypertension respond well to treatment intensification, regardless of their degree of adherence to anti-hypertensive medications, show new study.
"Despite a lack of evidence, many clinicians assume that 'nonadherent' patients cannot benefit from treatment intensification," said the study's lead author, Dr. Adam Rose, an assistant professor of medicine at BUSM and investigator at the Bedford Veterans Administration Medical Center in Bedford Mass.
"Our study calls this assumption into question.
"One of the major contributions of this study is to remind us that adherence is not a binary concept, with patients divided into those who are 'adherent' or 'nonadherent,'" he added.
During the study, researchers from Boston University School of Medicine (BUSM) studied 819 patients with hypertension.
Their adherence to BP medications were assessed using electronic bottle caps that record all bottle openings and provide a detailed record of pill-taking.
Patients were further divided into five groups: those with the best adherence, next-best, fair, poor and patients who did not return their electronic bottle cap (missing adherence).
They found that the effect of treatment intensification upon the final blood pressure was similar in all five adherence groups.
The investigators concluded that treatment intensification could improve blood pressure control for patients with varying levels of adherence to therapy.
However, Rose recommends that further studies be undertaken to determine the most effective management strategy for patients with uncontrolled hypertension and suboptimal adherence.