Adherence to prescribed medications in patients with heart failure – insights from liquid chromatography-tandem mass spectrometry-based urine analysis

Simpson, J. et al. (2021) Adherence to prescribed medications in patients with heart failure – insights from liquid chromatography-tandem mass spectrometry-based urine analysis. European Heart Journal: Cardiovascular Pharmacotherapy, 7(4), pp. 296-301. (doi: 10.1093/ehjcvp/pvaa071) (PMID:32597982) (PMCID:PMC8302254)

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Abstract

Aims: None of the existing studies on adherence have directly measured levels of medications (or their metabolites) in patients with heart failure. Methods and Results: We used liquid chromatography-tandem mass spectrometry to measure the presence of prescribed drugs (diuretics, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists) in the urine of patients reviewed 4 to 6 weeks after hospitalisation with heart failure. Patients were unaware that adherence was being assessed. Of the 341 patients studied, 281 (82.4%) were adherent i.e. had all prescribed drugs of interest detectable in their urine. Conversely, 60 patients (17.6%) were partially or completely non-adherent. Notably, 24 of the 60 were non-adherent to only diuretic therapy and only 7 out of all 341 patients studied (2.1%) were completely non-adherent to all prescribed heart failure drugs. There were no major differences in baseline characteristics between adherent and non-adherent patients. Conclusion: Non-adherence, assessed using a single spot urine measurement of drug levels, was confirmed in 1 of 5 patients evaluated 4 to 6 weeks after hospitalisation with heart failure.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Simpson, Dr Joanne and Jackson, Dr Colette and Jhund, Dr Pardeep and Petrie, Professor Mark and McMurray, Professor John and Gardner, Professor Roy and Haig, Dr Caroline
Authors: Simpson, J., Jackson, C. E., Haig, C., Jhund, P. S., Tomaszewski, M., Gardner, R. S., Tsorlalis, Y., Petrie, M. C., McMurray, J. J.V., Squire, I. B., and Gupta, P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:European Heart Journal: Cardiovascular Pharmacotherapy
Publisher:Oxford University Press
ISSN:2055-6837
ISSN (Online):2055-6845
Published Online:29 June 2020
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in European Heart Journal: Cardiovascular Pharmacotherapy 7(4): 296-301
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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