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Objective measures of non-adherence in cardiometabolic diseases: a review focused on urine biochemical screening

Dan Lane1,2, Prashanth Patel2,3, Kamlesh Khunti1

  • 1Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester, UK, dan.lane@uhl-tr.nhs.uk.

Patient Preference and Adherence
|May 3, 2019
PubMed

Insights

Non-adherence to medication for cardiometabolic diseases like cardiovascular disease (CVD) and diabetes mellitus (DM) is common. Biochemical testing, especially urine screening, is now a recommended tool to improve adherence and reduce healthcare costs.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Cardiometabolic diseases are prevalent global health issues.
  • Polypharmacy for these conditions often leads to medication non-adherence.
  • Suboptimal adherence worsens disease control, increasing hospitalizations, mortality, and costs.

Purpose of the Study:

  • To review the prevalence, impact, and reasons for non-adherence in cardiometabolic diseases.
  • To evaluate current adherence diagnostic tools, focusing on biochemical testing.
  • To assess the benefits of biochemical non-adherence testing in clinical practice.

Main Methods:

  • Literature review of current studies on medication adherence in cardiometabolic diseases.
  • Focus on biochemical testing, particularly urinary screening methods.
  • Evaluation of diagnostic and therapeutic benefits of adherence testing.

Main Results:

  • Lack of a gold standard previously hindered understanding of non-adherence prevalence and impact.
  • European guidelines now endorse biochemical testing for non-adherence in CVD.
  • Urinary screening is a clinically widespread method with significant health economic benefits.
  • Biochemical tests offer a snapshot, potentially influenced by pharmacokinetics.

Conclusions:

  • Medication non-adherence is a significant challenge in managing cardiometabolic diseases.
  • Biochemical testing, especially urinary screening, is a valuable tool for assessing adherence.
  • Adherence testing can lead to reduced hospitalizations, lower economic burdens, and improved patient outcomes.

Keywords:
LC-MS/MSadherencebiochemical testcardiovascular diseasediabetes mellitus

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