Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/329327
Type: Artigo
Title: A Practical Approach For Measurement Of Antihypertensive Medication Adherence In Patients With Resistant Hypertension
Author: Correa
Nathalia Batista; de Faria
Ana Paula; Ritter
Alessandra M. V.; Sabbatini
Andrea Rodrigues; Almeida
Aurelio; Brunelli
Veridiana; Calhoun
David A.; Moreno
Heitor; Modolo
Rodrigo
Abstract: Confirmation of medication adherence is a challenge in clinical practice and essential for the accurate diagnosis of resistant hypertension. Although it is well established that drug adherence is critical for controlling blood pressure, there are still difficulties applying a simple, inexpensive, and reliable assessment of adherence in the clinical setting. We aimed to test a simple method to assess adherence in resistant hypertensive (RH) patients. A pilot study with normotensives or mild/moderate hypertensive subjects was performed to provide a fluorescence cutoff point for adherence. After that, 21 patients referred to the Resistant Hypertension Clinic had triamterene prescribed and were monitored for a 30-day period. We conducted two unannounced randomly selected home visits for urine collection to test drug intake that day. Office, home and 24-hour ambulatory blood pressure, biochemical data, and the 8-item Morisky Medication Adherence Scale (MMAS-8) were systematically acquired. According to adherence indicated by urine fluorescence, subjects were divided into adherent and nonadherent groups. We found 57% of nonadherence. No differences were found between groups regarding Baseline characteristics or prescribed medications; Kappa's test showed concordance between adherence through MMAS-8 items and fluorescence (kappa = 0.61; 95% confidence interval: 0.28-0.94; P = .005). Nonadherent patients had higher office (81 11 vs. 73 6 mm Hg, P = .03), 24-hour ambulatory blood pressure monitoring (75 9 vs. 66 7 mm Hg, P = .01), and home blood pressure measurement (77 +/- 9 vs. 67 +/- 8 mm Hg, P = .01) diastolic blood pressure than their counterparts. Nonadherence to antihypertensive therapy is high in patients with RH, even when assessed in clinics specialized in this condition. Fluorometry to detect a drug in the urine of RH patients is safe, easy, and reliable method to assess adherence. (C) 2016 American Society of Hypertension. All rights reserved.
Subject: Pharmacological Adherence
Refractory Hypertension
Triamterene
Urine Fluorescence
Editor: Elsevier Science Inc
New York
Rights: fechado
Identifier DOI: 10.1016/j.jash.2016.03.194
Address: http://www.sciencedirect.com/science/article/pii/S1933171116302339?via%3Dihub
Date Issue: 2016
Appears in Collections:Unicamp - Artigos e Outros Documentos

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