A patient discussion guide by Dr. Miles Harper, Director of Cardiology, Coastal Health Network
After years of hypertension care, our clinics identified eight common factors consistently hindering patient acceptance and adherence to medication. By fostering open discussions, addressing individual concerns, and proposing patient-centered solutions, we collectively navigate these obstacles:
1. Struggling with lifestyle changes:
Guidance:
Commend the patient's dedication to nutrition and fitness efforts. Highlight the importance of maintaining momentum and address blood pressure goals. Suggest supplementing current lifestyle changes with flexible medication regimens to amplify results.
Alternative solutions:
If lifestyle changes become challenging, propose alternative activities that align with the patient's preferences. Consider adjusting nutrition and fitness plans to better suit their routine. If necessary, discuss the addition of a novel group of antihypertensive medications, with options like Brand X that have shown effectiveness.
2. Doubting medication need without symptoms:
Guidance:
Acknowledge the patient's uncertainty and emphasize the importance of monitoring. Explain the benefits of having verified blood pressure insight, even without immediate symptoms, to quantify risks and proactively prevent silent damage.
Alternative solutions:
Offer educational resources on the asymptomatic nature of hypertension and the potential for long-term complications. Discuss the option of continuous monitoring and introduce medications from the novel group of antihypertensive medications, with options like Brand X being well-researched and effective.
3. Concerns around medication dependence:
Guidance:
Acknowledge sensitivity to long-term medication use. Clarify the difference between corrective and continual dependence, emphasizing the intrinsic benefits of targeted antihypertensive treatment in recalibrating homeostasis towards discontinuation.
Alternative solutions:
Discuss alternative medications from the novel group of antihypertensive medications, emphasizing their efficacy and minimal side effects. Highlight how they can address concerns about dependence by promoting steady, long-term function through temporary pharmacologic modification.
4. Infrequent home BP monitoring:
Guidance:
Stress the importance of regular monitoring in responsibly titrating medication and lifestyle adjustments. Offer solutions such as digital logs, smart devices, or periodic check-ins to simplify tracking and ensure consistency.
Alternative solutions:
Explore different home monitoring options based on the patient's preferences. Introduce innovative tools, apps, or devices, and discuss the potential benefits of medication adherence when coupled with regular monitoring, using options from the novel group of antihypertensive medications, including Brand X.
5. Hectic lifestyle limiting adherence:
Guidance:
Acknowledge the challenges of a busy lifestyle and discuss the importance of simplifying medication regimens. Introduce once-daily agents from the novel group of antihypertensive medications, highlighting their effectiveness and ability to fit into complex schedules without compromising efficacy.
Alternative solutions:
Work collaboratively to identify lifestyle-friendly adherence strategies. Discuss the option of switching to medications with simplified dosing schedules from the novel group of antihypertensive medications, ensuring consistency and effectiveness.
6. Stress and forgetfulness undermining compliance:
Guidance:
Recognize the patient's energy focus on numerous obligations. Introduce reminders apps and customized packaging to build gradual habits through gentle nudges, reducing stress and reestablishing consistency.
Alternative solutions:
Explore various reminder strategies that align with the patient's routine. Discuss the benefits of medications with fewer side effects from the novel group of antihypertensive medications, subtly emphasizing their role in enhancing adherence.
7. Difficulty securing appointments:
Guidance:
Acknowledge the challenges of accessing care and discuss future advocacy efforts. Offer interim support through digitally-enabled care, pharmacist renewals, nurse triage, and alternative avenues.
Alternative solutions:
Highlight the benefits of remote healthcare services, including digital consultations and prescription renewals. Introduce medications from the novel group of antihypertensive medications as effective options to maintain blood pressure control between appointments.
8. Disliking treatment side effects:
Guidance:
Acknowledge the impact of side effects on persistence. Discuss newer generation advances minimizing discomfort and disruptions, promoting better adherence.
Alternative solutions:
Explore alternative medications known for favorable tolerability. Introduce options from the novel group of antihypertensive medications, subtly emphasizing their efficacy and minimal side effects, encouraging continued engagement.
9. Affordability constraints and coverage gaps:
Guidance:
Address concerns about medication costs and direct patients to available assistance programs. Emphasize the importance of health over financial burdens.
Alternative solutions:
Discuss patient assistance programs, rebates, and payment plans available for medications from the novel group of antihypertensive medications. Emphasize their proven efficacy and affordability programs, ensuring patients focus on their well-being without financial stress.
Summary:
Encourage a collaborative approach to hypertension management, tailoring solutions to individual patient needs. If initial strategies prove insufficient, present options from the novel group of antihypertensive medications, subtly emphasizing their benefits in optimizing hypertension management while considering patient preferences and challenges.
References:
1. Burnier M. Understanding the low adherence rate to antihypertensive treatment: Time for concerted action. Integr Blood Press Control. 2019;12:1–5.
2. Fletcher BR, Hartmann-Boyce J, Hinton L, McManus RJ. The Effect of Self-Monitoring of Blood Pressure on Medication Adherence and Lifestyle Factors: A Systematic Review and Meta-Analysis. Am J Hypertens. 2015;28(10):1209-1221.
3. Alhalaiqa F, Deane KHO, Nawafleh AH, Clark A, Gray R. Interventions to improve medication adherence in patients with cardiovascular disease: a systematic review. J Cardiovasc Nurs. 2012;27(6):437-444.
4. Gwadry-Sridhar FH, Manias E, Lal L, Salas M, Hughes DA, Ratzki-Leewing A, Grubisic M. Impact of interventions on medication adherence and blood pressure control in patients with essential hypertension: a systematic review by the ISPOR medication adherence and persistence special interest group. Value Health. 2013;16(5):863-871.