Patient non-compliance in hypertension
Frederick Mahomed is credited with discovering hypertension around 1870 while serving his medical residency at London’s Guy’s Hospital. Yet, a century and a half later, a quick search of the medical literature returns a wealth of blood pressure and hypertension studies, many with limited, suggested, and sometimes contradicting conclusions. Another query returns a partial list of over sixty hypertension drugs (US) and treatments involving at least two prescriptions. Viewed from a decision-making frame of reference, the number of potential drug combinations is practically impractical. These and related shortcomings leave many patients so frustrated that more than half walk away from crucially needed care.
I discussed the disconnect between patient non-compliance and hypertension’s known threats to life and health with @Prof.ArikEisenkraft, MD, MHA, Biobeat’s VP of Clinical & Regulation. His clinical insights and experience, supported by published research, point to confusing, cumbersome, and lengthy diagnostics and monitoring protocols, compounded by treatments that often prove ineffective and are incompatible with patients’ jobs and lifestyles. These factors contribute to treatment burden, which correlates negatively to patient experience, engagement, and compliance. Taken together, these and related factors illuminate the complexity of diagnosing, treating, and managing hypertension. They also point to opportunities for reducing treatment burden and compliance barriers through alternative strategies enabled by better information. ABPM’s reports, for example, break down blood pressure (systolic and diastolic), heart rate, systemic vascular resistance, and mean arterial pressure by time of day and night, daytime and nighttime averages, and dipping index. Online plots provide integrated views that help clinicians analyze patient profiles and share with patients compelling details of their blood pressure. The information and presentation make possible deeper understandings, collaboration, and shared decisions between clinicians and their patients. The reports allow clinicians to show patients how well their drug therapies are working, why drugs and dosage may need to change, and how their collaborations deliver positive outcomes. Once effective treatments are in place, the system allows clinicians to easily and quickly rerun tests to review long-term hypertension management, adjust treatments, and sustain their close collaboration with patients. These are just highlights of how innovative technologies like ABPM can change the dynamics of disease management. They also illustrate how best practices in collaborative decision-making and decision-sharing can be used to reduce treatment burden and other barriers that correlate with patient non-compliance. In upcoming posts, I will offer examples of how hypertension treatments can conflict with patients' lifestyle needs.