Clin Hypertens.  2021;27(1):26. 10.1186/s40885-021-00183-1.

Clinical impact of guideline-based practice and patients’ adherence in uncontrolled hypertension

Affiliations
  • 1Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
  • 2Department of Cardiology, CHA University Gangnam Medical Center, Seoul, Republic of Korea
  • 3Wonju Severance Christian Hospital, Yonsei University Health System, Wonju, Republic of Korea
  • 4Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  • 5Eulji General Hospital, Seoul, Republic of Korea
  • 6Inje University Haeundae Paik Hospital, Busan, Republic of Korea
  • 7Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
  • 8Korea University Ansan Hospital, Ansan, Republic of Korea
  • 9National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
  • 10Kosin University Gospel Hospital, Busan, Republic of Korea
  • 11Inje University Busan Paik Hospital, Busan, Republic of Korea
  • 12Dankook University Hospital, Cheonan, Republic of Korea
  • 13Keimyung University Dongsan Hospital, Daegu, Republic of Korea
  • 14Ajou University Hospital, Suwon, Republic of Korea
  • 15Yeungnam University Hospital, Daegu, Republic of Korea
  • 16Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
  • 17Seoul National University Hospital, Seoul, Republic of Korea
  • 18Viatris Korea Ltd., Seoul, Republic of Korea
  • 19Pfizer Korea, Seoul, Republic of Korea
  • 20Korea University College of Medicine, Seoul, Republic of Korea

Abstract

Background
Chronic diseases like hypertension need comprehensive lifetime management. This study assessed clinical and patient-reported outcomes and compared them by treatment patterns and adherence at 6 months among uncontrolled hypertensive patients in Korea.
Methods
This prospective, observational study was conducted at 16 major hospitals where uncontrolled hypertensive patients receiving anti-hypertension medications (systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg) were enrolled during 2015 to 2016 and studied for the following 6 months. A review of medical records was performed to collect data on treatment patterns to determine the presence of guideline-based practice (GBP). GBP was defined as: (1) maximize first medication before adding second or (2) add second medication before reaching maximum dose of first medication. Patient self-administered questionnaires were utilized to examine medication adherence, treatment satisfaction and quality of life (QoL).
Results
A total of 600 patients were included in the study. Overall, 23% of patients were treated based on GBP at 3 months, and the GBP rate increased to 61.4% at 6 months. At baseline and 6 months, 36.7 and 49.2% of patients, respectively, were medication adherent. The proportion of blood pressure-controlled patients reached 65.5% at 6 months. A higher blood pressure control rate was present in patients who were on GBP and also showed adherence than those on GBP, but not adherent, or non-GBP patients (76.8% vs. 70.9% vs. 54.2%, P < 0.001). The same outcomes were found for treatment satisfaction and QoL (P < 0.05).
Conclusions
This study demonstrated the importance of physicians’ compliance with GBP and patients’ adherence to hypertensive medications. GBP compliance and medication adherence should be taken into account when setting therapeutic strategies for better outcomes in uncontrolled hypertensive patients.

Keyword

Treatment adherence and compliance; Quality of life; Patient satisfaction
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