Author:
Trimarco Valentina,Manzi Maria Virginia,Izzo Raffaele,Mone Pasquale,Lembo Maria,Pacella Daniela,Esposito Giovanni,Falco Angela,Morisco Carmine,Gallo Paola,Santulli Gaetano,Trimarco Bruno
Abstract
BackgroundAdverse 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.MethodsThe 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).ResultsWe 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%).ConclusionOur findings indicate that the therapeutic concordance approach significantly reduces ADRs in TRH patients.
Funder
National Institutes of Health (NIH): National Heart, Lung, and Blood Institute
National Institute of Diabetes and Digestive and Kidney Diseases
National Center for Advancing Translational Sciences
Diabetes Action Research and Education Foundation (to GS), and by the Monique Weill-Caulier and Irma T. Hirschl Trusts
Subject
Cardiology and Cardiovascular Medicine
Cited by
4 articles.
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