What is the clinical evidence from this study?

Study design: Cohort. Population: apparent treatment-resistant hypertension (n=35). Intervention: Psychological profile. Primary outcome: Drug adherence and drug resistance.

June 28, 2018Blood PressureOpen Access

Impact of psychological profile on drug adherence and drug resistance in patients with apparently treatment-resistant hypertension

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Key result

Psychological characteristics strongly predicted poor drug adherence (accounting for 51% of variability) and treatment resistance (accounting for 37% of variability) in patients with aTRH.

Why the study?

Do psychological characteristics predict drug adherence and drug resistance in patients with apparent treatment-resistant hypertension?

Population

35 consecutive patients with confirmed apparent treatment-resistant hypertension on standardized…

Design

Cohort

Authors

GPGéraldine PetitCliniques Universitaires Saint-Luc EBE. BerraCliniques Universitaires Saint-Luc CGCoralie M.G. GeorgesCliniques Universitaires Saint-Luc

Discussion

Member takes

Implication

Psychological screening may aid aTRH assessment; hypothesis-generating for intervention trials before practice change.

Key Points

To identify predictors of drug adherence and treatment resistance in patients with apparent treatment-resistant hypertension, focusing on specific psychological characteristics.
Enrolled 35 consecutive patients with confirmed apparent treatment-resistant hypertension on standardized antihypertensive therapy.
Quantified drug adherence objectively via urine liquid chromatography-tandem mass spectrometry (LC-MS/MS) and evaluated treatment resistance using 24-hour ambulatory blood pressure adjusted for drug count and adherence.
Characterized psychological profiles across coping strategies and somatization using a panel of validated questionnaires.
Urine analysis classified 29% of patients as adherent, 40% as partly adherent, and 31% as totally non-adherent to their prescribed regimens.
Recent hospitalization for hypertension, reduced perspective-taking, and elevated somatization independently predicted poor adherence, accounting for 51% of variance.
Greater reliance on blaming oneself and blaming others independently predicted true treatment resistance, explaining 37% of variance.

Study Design

Type

Cohort (n=35)

Structured PICO

Do psychological characteristics predict drug adherence and drug resistance in patients with apparent treatment-resistant hypertension?

Population

35 consecutive patients with confirmed apparent treatment-resistant hypertension on standardized antihypertensive treatment.

Exposure

Psychological profile assessment using validated questionnaires

Outcome

Drug adherence (assessed by drug dosages in urine using LC-MS/MS) and drug resistance (assessed by 24-hour ambulatory blood pressure adjusted for the number of antihypertensive drugs and for drug adherence)surrogate

Psychological characteristics are strong independent predictors of both drug adherence and drug resistance in patients with apparent treatment-resistant hypertension, suggesting psychological evaluation should be integrated into their assessment.

Cite This Study

Petit et al. (2018) conducted a cohort in apparent treatment-resistant hypertension (n=35). Psychological profile was evaluated on Drug adherence and drug resistance. Psychological characteristics strongly predicted poor drug adherence (accounting for 51% of variability) and treatment resistance (accounting for 37% of variability) in patients with aTRH.

synapsesocial.com/papers/6a9d7b2d35d8a1c1e38b0399 https://doi.org/10.1080/08037051.2018.1476058

Topics

Hypertension management

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Impact of psychological profile on drug adherence and drug resistance in patients with apparently treatment-resistant hypertension

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Impact of psychological profile on drug adherence and drug resistance in patients with apparently treatment-resistant hypertension

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

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