Imperial College London
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Dr Paz (Upasana) Tayal

Faculty of Medicine, National Heart & Lung Institute

Clinical Senior Lecturer in Cardiology
 
 
 
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Contact

 

u.tayal14

 
 
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Location

 

Cardiovascular BRUSydney StreetRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Sweeney:2021:10.1002/ehf2.13284,
author = {Sweeney, M and Cole, GD and Pabari, P and Hadjiphilippou, S and Tayal, U and Mayet, J and Chapman, N and Plymen, CM},
doi = {10.1002/ehf2.13284},
journal = {ESC Heart Failure},
pages = {2334--2337},
title = {Urinary drug metabolite testing in chronic heart failure patients indicates high levels of adherence with life-prolonging therapies},
url = {http://dx.doi.org/10.1002/ehf2.13284},
volume = {8},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - AimsDespite medical therapy for heart failure (HF) having proven benefits of improving quality of life and survival, many patients remain under-treated. This may be due to a combination of under-prescription by medical professionals and poor adherence from patients. In HF, as with many other chronic diseases, adherence to medication can deteriorate over time particularly when symptoms are well controlled. Therefore, detecting and addressing non-adherence has a crucial role in the management of HF. Significant flaws and inaccuracies exist in the methods currently used to assess adherence such as patient reporting, pill counts, and pharmacy fill records. We aim to use high-performance liquid chromatography–tandem mass spectrometry (HPLC-MS) to detect metabolites of HF medications in the urine samples of chronic HF patients.Methods and resultsUrine samples were collected from 35 patients in a specialist HF clinic. Patients were included if they had an ejection fraction <45% and were taking at least two disease-modifying HF medications. They were excluded if they had been admitted to hospital for HF in the 3 months preceding clinic attendance. These samples were sent for HPLC-MS and tested for all HF medications prescribed for that patient. A high rate of complete adherence of 89% was detected in these patients, with 94% being partially adherent (at least one HF medication detected) to therapy (at least one HF medication detected). This analysis also highlighted that mineralocorticoid antagonists represent both the most under-prescribed (67%) and poorly adhered (75%) medication class.ConclusionsThis analysis revealed a surprisingly high level of adherence to disease-modifying therapy in chronic HF patients and highlights that most of our ‘total’ under-treatment is likely to be from a failure to prescribe rather than a failure to adhere. Testing for metabolites of disease-modifying HF drugs in urine using HPLC-MS is feasible and is a useful adjunct t
AU  - Sweeney,M
AU  - Cole,GD
AU  - Pabari,P
AU  - Hadjiphilippou,S
AU  - Tayal,U
AU  - Mayet,J
AU  - Chapman,N
AU  - Plymen,CM
DO  - 10.1002/ehf2.13284
EP  - 2337
PY  - 2021///
SN  - 2055-5822
SP  - 2334
TI  - Urinary drug metabolite testing in chronic heart failure patients indicates high levels of adherence with life-prolonging therapies
T2  - ESC Heart Failure
UR  - http://dx.doi.org/10.1002/ehf2.13284
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000627601500001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
UR  - https://onlinelibrary.wiley.com/doi/10.1002/ehf2.13284
UR  - http://hdl.handle.net/10044/1/104376
VL  - 8
ER  -
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