Addressing Medication Non-adherence in Patients With Poorly Controlled Hypertension Using Urine Mass Spectrometry

Condition(s) studied

Investigational drug(s) / intervention(s)

mass spectrometry analysis: The collected urine samples will be analyzed to determine medication adherence during study visits

Study summary

* Hypertension is the single largest contributor to cardiovascular disease and death. While adequate control of hypertension reduces risk of disease, many patients have uncontrolled hypertension. This is often due to medication non-adherence. Left undetected, patients are prescribed additional medications, and referred to multiple specialists for investigations - leading to increased healthcare costs. Hence, detecting non-adherence to antihypertensive medications is important. However, patient history, patient recall, or questionnaires, are often inaccurate. Most recently, urine measurements of antihypertensive drug levels, using mass spectrometry, has been established as the gold standard to assess medication adherence. The one-time urine test for medication adherence is ideal: It's convenient, non-invasive, economical, and can be easily performed in a clinic setting. By improving blood pressure control, this will lead to reductions in healthcare visits, avoidance of catastrophic cardiovascular events. Ultimately, this translates to significant economic savings for both patients with hypertension and the healthcare system.
* Therefore, the investigators hypothesize that the implementation of urine adherence testing coupled with targeted counselling will improve the adherence and blood pressure control in hypertension. To do this, the investigators aim to (1) evaluate for medication adherence in 312 participants with recent stroke and hypertension; (2) evaluate for medication non-adherence in participants with uncontrolled hypertension; and (3) assess if detection of non-adherence can improve hypertension control.

Eligibility

Primary outcome measure(s)

• Change in adherence rate — 6 months
  This is the difference in the adherence rates at enrollment and at the end of the study
• The change in systolic blood pressure — 6 months
  This is the difference in systolic blood pressure between enrollment and the last follow up visit at 6 months
• The change in diastolic blood pressure — 6 months
  This is the difference in diastolic blood pressure between enrollment and the last follow up visit at 6 months

Trial sites (1)

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