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[Compliance in hypertensive patients and patients with cardiac insufficiency]
Insights
Patient drug adherence was assessed using urine fluorescence. While overall compliance was good, it decreased over time, suggesting treatment duration impacts adherence and necessitates early intervention strategies.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Patient Adherence Research
Context:
- Investigating drug adherence in patients with hypertension, heart failure, and edema.
- Utilizing the urine fluorescence method for objective compliance measurement.
- Observing 83 patients over an average period of 17.8 weeks.
Purpose:
- To assess the drug-compliance rate in a cohort of cardiovascular patients.
- To identify factors influencing patient adherence to prescribed medications.
- To evaluate the trend of compliance throughout the treatment duration.
Summary:
- Mean compliance was 79.7%, with individual rates varying widely.
- Symptomatic patients showed slightly higher, though not statistically significant, compliance than hypertensive patients.
- A continuous decrease in compliance was observed from the first visit (82%) to the fifth (56%).
Impact:
- Findings suggest treatment duration is a key determinant of drug adherence.
- Highlights the need for early implementation of compliance-improving strategies.
- Results indicate a need for proactive interventions to maintain patient adherence over time.
Abstract:
In the present study the compliance or drug-adherence of 83 patients with hypertension (n = 66), heart failure (n = 14) or edema of non-cardiac origin (n = 3) was investigated by the urine fluorescence method over an observation period of 17.8 +/- 15.1 weeks. Mean compliance rate of all patients was 79.7%. Individual drug-adherence ranged from 0 to 100%. Half of the patients (54.2%; n = 45) had positive urine samples in all investigations performed. A quarter (25.3%; n = 21) were compliant in over 50%, whereas in 14.5% (n = 12) the drug could be detected in the urine in only 10 to 50% of the tests and in 6% (n = 5) in less than 10%. The 17 symptomatic patients (patients with heart failure and/or edemas) showed a slightly better compliance (87.0%) than patients with hypertension, who had positive urine samples in 77.3 +/- 30.1% of tests. However, the difference observed was not statistically significant. During treatment a decrease in compliance from 82% at the first visit to 73% and 75% respectively at the second and third could be observed. Finally, at the fourth and fifth consultation only 62.2% and 56% respectively of the patients had positive urine samples. Our results show a good compliance rate in our patients as compared to American studies. During treatment a continuous decrease in compliance could be observed. Our results indicate that the duration of treatment seems to be an important determinant for the patient's drug-adherence. Therefore, it appears necessary to perform compliance-improving strategies as early as after the first follow-up visits.