Abstract: FR-PO1056
Determination of Adherence to Antihypertensive Medications by Urine Testing In Patients with Advanced CKD
Session Information
- Hypertension and CVD: Clinical Outcomes, Trials
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)
- 1800 Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)
Authors
- Bae, Se ri, University of California, San Francisco, California, United States
- Lerma, Mariel, University of California, San Francisco, California, United States
- Black, Elizabeth Ashley, University of California, San Francisco, California, United States
- Hsu, Raymond K., University of California, San Francisco, California, United States
- Ku, Elaine, University of California, San Francisco, California, United States
Background
Our objective was to assess blood pressure (BP) medication adherence and its predictors in adults with advanced CKD using KardiAssure, a commercially available urine test that detects a comprehensive battery of BP medications. We also aimed to compare assessments of medication adherence by providers and study coordinators compared to KardiAssure testing in the clinical and research setting.
Methods
Participants with advanced CKD (stage 4-5) in a randomized pilot trial were included. Urine specimens were collected at baseline and 4-month follow up visits. Adherence was defined as agreement between patient-reported BP medications and medications detected by KardiAssure. Providers and study coordinators were surveyed regarding their perceptions of patient BP medication adherence. Logistic models were used to examine predictors of adherence.
Results
We included 57 patients at baseline and 40 patients at the 4-month follow-up for study. Mean age was 54±17 years; 58% were male; mean baseline eGFR was 22 mL/min/1.73m2. Diuretics and beta blockers were the the most common agents that patients were non-adherent to by KardiAssure testing (27% and 23%, respectively). Providers and coordinators identified adherence accurately but significantly under-estimated non-adherence (Figure). Factors predictive of adherence included provider perceptions of adherence and female sex.
Conclusion
Non-adherence is common in patients with advanced CKD, especially to diuretics and beta-blockers. Further studies are needed to understand how to best assess adherence in clinical practice and research studies and identify reasons for selective adherence to different classes of BP agents.
Funding
- Other NIH Support – Aegis Sciences Corporation