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Therapy and guideline adherence at a multidisciplinary hypertension clinic: A prospective, observational study
Julie Hias1, Lise Defieuw2, Thomas Vanassche3
1Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium; Hospital Pharmacy Department, University Hospitals Leuven, Leuven, Belgium.
Insights
A hypertension clinic visit improved doctor adherence to guidelines. Pharmacist involvement may further enhance patient adherence and treatment success for better blood pressure control.
Area of Science:
- Cardiology
- Clinical Pharmacy
- Public Health
Background:
- Hypertension is a prevalent condition contributing significantly to cardiovascular morbidity and mortality.
- Suboptimal blood pressure control remains a common challenge despite available treatments.
- Specialized hypertension clinics offer a potential strategy to improve treatment outcomes.
Purpose of the Study:
- To assess patient adherence to antihypertensive drug therapy.
- To evaluate prescriber compliance with hypertension guidelines.
- To characterize pharmacist interventions within a hypertension clinic setting.
Main Methods:
- A prospective observational study was conducted at an academic hospital's hypertension clinic.
- Data collected included patient demographics, medication use, adherence (BAASIS tool), and guideline compliance (2018 ESC guidelines).
- Pharmacist interventions and recommendations were also recorded.
Main Results:
- 108 patients were included; 44.2% exhibited non-adherence to antihypertensive treatment.
- 78.8% of patients had suboptimal blood pressure control.
- Prescriber guideline compliance increased from 66.3% to 77.9% post-clinic consultation (p=0.0015).
Conclusions:
- Multidisciplinary hypertension clinic visits enhance prescriber guideline adherence and single pill combination use.
- Clinical pharmacist involvement shows promise for improving patient adherence and guideline compliance.
- Optimizing hypertension management through specialized clinics and pharmacist collaboration is crucial.
Background:
Hypertension is highly prevalent and remains one of the most frequent and preventable causes of cardiovascular morbidity and mortality. Yet, suboptimal blood pressure control is common. Hypertension clinics might play an important role in improving target attainment, by targeting drug therapy adherence, improving guideline compliance and by involving pharmacists.
Objectives:
We aimed to characterize patient drug therapy adherence, prescriber guideline compliance and pharmacist interventions at the hypertension clinic.
Methods:
A prospective observational study was performed at the hypertension clinic of a large, academic hospital. Adult Dutch-speaking patients were eligible for inclusion. Following data were collected: patient demographics, medication use, patient adherence to prescribed antihypertensive drug therapies according to the BAASIS tool and prescriber compliance to the 2018 European Society of Cardiology (ESC) hypertension guidelines.
Results:
A cohort of 108 patients was included with 51.9% male and aged 65 (IQR: 52-75) years. In total, 104 patients took at least 1 antihypertensive drug and 46 patients (44.2%) were classified as non-adherent with regard to their antihypertensive treatment; 82 patients (78.8%) had suboptimal blood pressure control. Compliance with the ESC guidelines was 66.3% prior to the consultation at the clinic and significantly increased to 77.9% thereafter (p = 0.0015). The clinical pharmacist performed a medication review for 27 patients with a total of 44 recommendations and an acceptance rate of 59.1%.
Conclusion:
A visit to the multidisciplinary hypertension clinic improved prescriber guideline compliance and the use of single pill combinations. Involvement of a clinical pharmacist could be beneficial to further improve patient drug therapy adherence and guideline compliance.
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