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

• Published in: Clinical hypertension 2021, 27(4), , pp.78-84
• Main Authors: Sohn, Il Suk, Kim, Chong Jin, Yoo, Byung-Su, Kim, Byung Jin, Choi, Jae Woong, Kim, Doo-Il, Lee, Sang-Hak, Song, Woo-Hyuk, Jeon, Dong Woon, Cha, Tae Jun, Kim, Dae-Kyeong, Lim, Seong-Hoon, Nam, Chang-Wook, Shin, Joon-Han, Kim, Ung, Kwak, Jae-Jin, Park, Jun-Bean, Cha, Jin-Hye, Kim, Young-Joo, Choi, Jimi, Lee, Juneyoung
• Format: Article
• Language: English
• Subjects: Antihypertensive drugs; Antihypertensives; Asymptomatic; Blood pressure; Cardiovascular disease; Care and treatment; Comparative analysis; Drug dosages; Hypertension; Medical records; Medical research; Medicine, Experimental; Mortality; Patient compliance; Patient satisfaction; Physicians; Practice guidelines (Medicine); Quality of life; Treatment adherence and compliance; 내과학
• ISSN: 2056-5909; 1342-2154; 2635-6325; 2056-5909
• DOI: 10.1186/s40885-021-00183-1

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. 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). 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