Drug Adherence in Hypertension and Cardiovascular Protection

This book provides a critical and comprehensive review of the methodologies available for measuring drug adherence in clinical practice, including those relying on emerging technologies. The authors discuss the risk factors of non-adherence and shed light on how to identify patients at risk of poor adherence. Drug therapies in chronic diseases rely heavily on the patient's adherence, since drugs that are not taken are ineffective and leave the patient at high risk of developing clinical complications. Given the absence of new drugs for the treatment of hypertension, drug adherence is particularly important in these patients to improve blood pressure control. The book further investigates a new aspect, namely the importance of drug adherence in clinical trials and studies and draws attention to the limits of developing drugs without significant information on drug adherence. Several chapters are dedicated to the importance of adherence in specific forms of hypertension, such as resistant hypertension, dyslipidemia and hypertension associated with cardiovascular risk. As experts confronted with drug adherence in their daily practice, the authors analyse the real effectiveness of several interventions aimed at improving drug adherence and put particular emphasis on the importance of an interdisciplinary approach involving nurses and pharmacists. The volume also includes a careful analysis of the health and economic impact of poor adherence. The book is aimed at physicians, pharmacists, students and all health professionals dealing not only with hypertension or dyslipidemia, but also with chronic asymptomatic diseases such as diabetes, HIV or chronic respiratory diseases.

1 Taxonomy of adherence.- I Measuring drug adherence.- 2 Qualitative assessment of adherence.- 3 Electronic monitoring of drug adherence.- 4 Measurements of drugs in plasma/urine.- 5 Assessing adherence measurement in large databases.- 6 Direct observed treatment in hypertension.- 7 Novel technologies for following drug adherence.- 8 Ethical aspects of measuring adherence II Risk factors for non-adherence.- 9 Determinants and barriers to adherence in CV diseases.- 10 Beliefs and adherence.- III Adherence in hypertension and CV protection.-  11 Impact of drug adherence in clinical trials.- 12 Drug adherence in essential hypertension: impact of drugs.- 13 Persistence in hypertension in general practice.- 14 Drug adherence in resistant hypertension.- 15 Drug adherence with cardiovascular medicines (statins).- 16 Adherence and cardiovascular risk.- IV Interventions to improve drug adherence.-  17 Which interventions are useful?.- 18 Use of fixed-dose combinations in CV diseaseprevention.- 19 Nurse-led intervention in Hypertension.- 20 Role of the Pharmacist in supporting adherence.-  21 Integrated approaches to support adherence.-  22 Use of Apps to improve drug adherence.-  V Health care consequences of non-adherence.- 23 Global clinical consequence of poor adherence.- 24 Cost of non-adherence.