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Introducing the importance and difficulties of a three-step approach to improve nonadherence to antihypertensive drugs: a case series.

Peeters, L.E.J., Net, J.B. van der, Schoenmakers-Buis, K., Meer, I.M. van der, Massey, E.K., Dijk, L. van, Gelder, T. van, Koch, B.C.P., Versmissen, J. Introducing the importance and difficulties of a three-step approach to improve nonadherence to antihypertensive drugs: a case series. Journal of Hypertension: 2022, 40(1), p. 189-193.
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Nonadherence to antihypertensive drugs is an important reason for not reaching blood pressure goals. A possible method to improve nonadherence involves three essential steps: identification of nonadherent patients (step 1), determination of underlying causes (step 2) and a personalized solution (step 3). We present three unique cases to show the importance and difficulties of this three-step approach.

Patients participated in a randomized controlled trial to improve nonadherence to antihypertensive drugs (RHYME-RCT, Dutch Trial Register NL6736). Drug level measurements were used to identify nonadherence to antihypertensive drugs and communication on drug levels was supported by a tailored feedback tool in these patients. These cases showed that a three-step approach of identifying nonadherence and determination of the underlying cause, can lead to a personalized solution to improve therapy even when nonadherence was excluded. Open communication with patients remains an essential part when improving nonadherence.