TY - JOUR
T1 - The therapeutic concordance approach reduces adverse drug reactions in patients with resistant hypertension
AU - Trimarco, Valentina
AU - Manzi, Maria Virginia
AU - Izzo, Raffaele
AU - Mone, Pasquale
AU - Lembo, Maria
AU - Pacella, Daniela
AU - Esposito, Giovanni
AU - Falco, Angela
AU - Morisco, Carmine
AU - Gallo, Paola
AU - Santulli, Gaetano
AU - Trimarco, Bruno
N1 - Publisher Copyright:
2023 Trimarco, Manzi, Izzo, Mone, Lembo, Pacella, Esposito, Falco, Morisco, Gallo, Santulli and Trimarco.
PY - 2023
Y1 - 2023
N2 - Background: Adverse drug reactions (ADRs) remain among the leading causes of therapy-resistant hypertension (TRH) and uncontrolled blood pressure (BP). We have recently reported beneficial results in BP control in patients with TRH adopting an innovative approach, defined as therapeutic concordance, in which trained physicians and pharmacists reach a concordance with patients to make them more involved in the therapeutic decision-making process. Methods: The main scope of this study was to investigate whether the therapeutic concordance approach could lead to a reduction in ADR occurrence in TRH patients. The study was performed in a large population of hypertensive subjects of the Campania Salute Network in Italy (ClinicalTrials.gov Identifier: NCT02211365). Results: We enrolled 4,943 patients who were firstly followed-up for 77.64 ± 34.44 months, allowing us to identify 564 subjects with TRH. Then, 282 of these patients agreed to participate in an investigation to test the impact of the therapeutic concordance approach on ADRs. At the end of this investigation, which had a follow-up of 91.91 ± 54.7 months, 213 patients (75.5%) remained uncontrolled while 69 patients (24.5%, p < 0.0001) reached an optimal BP control. Strikingly, during the first follow-up, patients had complained of a total of 194 ADRs, with an occurrence rate of 68.1% and the therapeutic concordance approach significantly reduced ADRs to 72 (25.5%). Conclusion: Our findings indicate that the therapeutic concordance approach significantly reduces ADRs in TRH patients.
AB - Background: Adverse drug reactions (ADRs) remain among the leading causes of therapy-resistant hypertension (TRH) and uncontrolled blood pressure (BP). We have recently reported beneficial results in BP control in patients with TRH adopting an innovative approach, defined as therapeutic concordance, in which trained physicians and pharmacists reach a concordance with patients to make them more involved in the therapeutic decision-making process. Methods: The main scope of this study was to investigate whether the therapeutic concordance approach could lead to a reduction in ADR occurrence in TRH patients. The study was performed in a large population of hypertensive subjects of the Campania Salute Network in Italy (ClinicalTrials.gov Identifier: NCT02211365). Results: We enrolled 4,943 patients who were firstly followed-up for 77.64 ± 34.44 months, allowing us to identify 564 subjects with TRH. Then, 282 of these patients agreed to participate in an investigation to test the impact of the therapeutic concordance approach on ADRs. At the end of this investigation, which had a follow-up of 91.91 ± 54.7 months, 213 patients (75.5%) remained uncontrolled while 69 patients (24.5%, p < 0.0001) reached an optimal BP control. Strikingly, during the first follow-up, patients had complained of a total of 194 ADRs, with an occurrence rate of 68.1% and the therapeutic concordance approach significantly reduced ADRs to 72 (25.5%). Conclusion: Our findings indicate that the therapeutic concordance approach significantly reduces ADRs in TRH patients.
KW - adherence
KW - adverse drug reactions
KW - blood pressure
KW - compliance
KW - concordance
KW - hypertension
KW - pharmacologic resistance
KW - resistant hypertension
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U2 - 10.3389/fcvm.2023.1137706
DO - 10.3389/fcvm.2023.1137706
M3 - Article
AN - SCOPUS:85159869704
SN - 2297-055X
VL - 10
JO - Frontiers in Cardiovascular Medicine
JF - Frontiers in Cardiovascular Medicine
M1 - 1137706
ER -