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Clinician's attitudes & perspective on chemical adherence testing in hypertension (CATCH): A qualitative interview
Roshan Shahab1, Louise Rabbitt2, Gerard J Molloy1
1School of Psychology, University of Galway, Galway, Ireland.
British Journal of Clinical Pharmacology
|January 22, 2026
Summary
Chemical Adherence Testing (CAT) shows promise for improving hypertension treatment adherence. However, clinicians noted practical and ethical challenges for widespread clinical adoption.
Area of Science:
- Clinical Pharmacology
- Hypertension Management
- Patient Adherence Research
Background:
- Chemical Adherence Testing (CAT) is emerging as a valid method to verify antihypertensive medication adherence.
- Understanding clinician perspectives is crucial for integrating new diagnostic tools into practice.
Purpose of the Study:
- To explore clinicians' attitudes and perspectives on the clinical utility of Chemical Adherence Testing (CAT).
- To identify potential facilitators and barriers to CAT implementation in hypertension care.
Main Methods:
- Purposive and snowball sampling recruited 9 clinicians from various specialties involved in hypertension care.
- Semi-structured interviews were conducted, and data were analyzed using reflexive thematic analysis.
Main Results:
- Clinicians viewed CAT as an objective tool for assessing non-adherence, particularly in treatment-resistant hypertension.
- Practical barriers include test availability, workflow integration, staffing, and cost.
- Ethical considerations involve patient trust, consent, and sensitive communication to avoid a punitive perception.
Conclusions:
- CAT is perceived as valuable for diagnostic clarity and initiating adherence discussions.
- Successful implementation hinges on addressing logistical feasibility, ethical use, and potential impacts on patient-clinician relationships.
- System-level support, clinician training, and clear communication are essential for patient-centered integration.
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