Strategies for Adherence to Treatments for Hypertension

Strategies for Adherence to Treatments for Hypertension


Hello, I’m Dr. Dan Jones, past President of the
American Heart Association, and professor of Medicine and Physiology at the University of
Mississippi Medical Center. With me today, is Dr. Paul Whelton, Chair of our new ACC/AHA Guidelines for the Management of High Blood Pressure. Dr. Whelton previously was CEO and President of Loyola University
Medical Center in Chicago. Presently, is Professor of Global Health in the School of Public Health in the School of Medicine
at Tulane University. Dr. Whelton, thank you for being with us. Thank you. Let’s talk a little bit
about how we implement these new guidelines that we have. So we have some patients who’ll be recommended for treatment that we’ve not treated before,
lifestyle or drug therapy, and we’ve had more aggressive
lowering of blood pressure in some patients,
especially older patients. So, would you give us some
clues on how the clinician might work toward implementing
these new guidelines? So, we know that it’s one
thing to recommend a treatment, and a it’s different thing
to actually implement it, and we provide a lot of
suggestions in our guideline as to how to be effective in implementing, and many of the clinicians
will be familiar with, certainly an important one is adherence. We know that many times, a treatment that is recommended isn’t taken, and it’s
not taken effectively, even if it’s started, so
always important to try to work with patients to ensure they understand the treatment, they’re taking the treatment. Take the time to have the conversation, and simple things like once-a-day dosing, rather than twice-a-day dosing, where there’s an appropriate combination, so the patient only has to add one pill, especially if they’re an older patient, they may be taking several other pills. Taking advantage of the
team that works with this, to be a team-based activity. That always helps a great deal, so there are a lot of other
suggestions that we have, and they’re taking
advantage of technology. We have a lot of technology that’s now from the electronic health record to tele-monitoring outside the office. These are all strategies
that help us to implement the treatments that we
think are beneficial. I want to ask you a little bit more about that team approach. Medicine is going through
tremendous change these days, and some of our clinicians like to control things. They like to talk to
the patient themselves, and not have other people
messing with their patients, so does this idea of team approach, having pharmacists and nurses
and other folks involved in decision-making and
care of the patients. Is there evidence that this is beneficial? There’s strong evidence
that it’s beneficial, and of course, where there’s a clinician who’s a physician
involved, it’s a great help to that physician, because they’re busy. They’ve got lots of things to do, so we know from a lot of
clinical trials that others, like nurses and pharmacists
can be very effective in management of high blood pressure, so definitely taking
advantage of the team, and of course, including the patient as a part of that team is very important, because we not only want to understand the pressures in the office, but we now recognize that working with the patient to have an understanding
of what’s happening outside the office is very helpful to our decisions to initiate therapy and to monitor that therapy over time. Thank you. I think our readers will find,
as they read the guidelines, that when they get to this section, they’ll find more help
about implementation than in previous guidelines,
and I encourage everyone to go to the guidelines and look at this and take advantage of the good
information that is there, the good evidence-based information. Dr. Whelton, thank you for your leadership of providing the guidelines
and for the conversation today. Thank you. Thank you, Dr. Jones.

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