AUTHOR=Trimarco Valentina , Manzi Maria Virginia , Izzo Raffaele , Mone Pasquale , Lembo Maria , Pacella Daniela , Esposito Giovanni , Falco Angela , Morisco Carmine , Gallo Paola , Santulli Gaetano , Trimarco Bruno 

TITLE=The therapeutic concordance approach reduces adverse drug reactions in patients with resistant hypertension

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1137706

DOI=10.3389/fcvm.2023.1137706

ISSN=2297-055X

ABSTRACT=Background: Adverse drug reactions (ADRs) are among the leading causes of therapy-resistant hypertension (TRH) and uncontrolled blood pressure (BP). We have recently reported beneficial results in BP control in patients with TRH adopting an innovative approach, defined as therapeutic concordance, in which trained physicians and pharmacists reach a concordance with patients to make them more involved in the therapeutic decision-making process, by adapting consultation style to meet patients’ needs and simplifying treatment regimens.
Methods: The aim of this study was to investigate whether the therapeutic concordance approach could lead to a reduction in ADR occurrence in TRH patients. The study was performed in a population of hypertensive patients of the Campania Salute Network in Italy (ClinicalTrials.gov Identifier: NCT02211365).
Results: We enrolled 4943 patients who were firstly followed-up for 77.64±34.44 months, allowing us to identify 564 subjects with TRH. Then, 282 of these patients agreed to participate in an investigation to test the impact of the therapeutic concordance approach on ADRs. At the end of this investigation, which had a follow-up of 91.91±54.7 months, 213 patients (75.5%) remained uncontrolled while 69 patients (24.5%, p<0.0001) reached an optimal BP control. Strikingly, during the first follow-up, patients had complained of a total of 194 ADRs, with an occurrence rate of 68.1% and the therapeutic concordance approach significantly reduced ADRs to 72 (25.5%,). 
Conclusion: Our findings indicate that the therapeutic concordance approach significantly reduces ADRs in TRH patients.