Key result
Adherence to antihypertensive drug therapy did not differ between patients with on-target versus not-on-target blood pressure (96% vs. 96%; p=0.91).
Why the study?
The authors sought to assess the role of adherence to antihypertensive drug therapy in blood pressure control among patients with type 2 diabetes treated in secondary care, alongside physician treatment intensification.
Does adherence to antihypertensive drug therapy improve blood pressure control in patients with type 2 diabetes?
Cohort (n=385)
Does adherence to antihypertensive drug therapy improve blood pressure control in patients with type 2 diabetes?
Absolute Event Rate: 96% vs 96%
p-value: p=0.91
High adherence to antihypertensive therapy does not guarantee blood pressure control in type 2 diabetes, highlighting clinical inertia as a major barrier since therapy was intensified in only 37% of uncontrolled patients.
Adherence monitoring alone may not ensure BP control in T2D; leaves open the contribution of clinical inertia to treatment gaps.
We studied the role of adherence to antihypertensive drug therapy (AHT) in blood pressure (BP) control in a type 2 diabetes (T2D) population treated in secondary care in the DIAbetes and LifEstyle Cohort Twente-1 (DIALECT-1). In addition, intensification of AHT was assessed. Adherence was determined by using the medication possession ratio (MPR), calculated with pharmacy dispensing data for a period of two years following baseline. Adherence was defined as an MPR ≥ 80%. The proportion of adherent patients was compared between patients who had BP-on target (BP-OT) and BP-not on target (BP-NOT). Of the 385 patients included, 56% achieved their BP target. The proportion of adherent patients did not differ between BP-OT and BP-NOT (96% vs. 96%; p = 0.91). Intensification of AHT, including ‘increase in dosage’ and ‘start of a new drug’, was assessed in the two years following baseline. In only 37% of patients with uncontrolled BP during follow-up was AHT intensified. To conclude, adherence to AHT was high and there does not seem to be a relationship between adherence and BP control. There is an opportunity to improve AHT in patients who do not reach their BP target.
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Dam et al. (2023) conducted a cohort in Type 2 diabetes (n=385). Adherence to antihypertensive drug therapy (AHT) vs. Non-adherence was evaluated on Proportion of adherent patients (MPR ≥ 80%) in BP-on target vs BP-not on target groups (p=0.91). Adherence to antihypertensive drug therapy did not differ between patients with on-target versus not-on-target blood pressure (96% vs. 96%; p=0.91).
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