Blood pressure drug screening in older patients

Aims

This study will test whether it is feasible to collect urine samples in from patients attending their GP and analyse them using a new method to detect blood pressure lowering drugs.

Why is this important?

Many older people take lots of different medications. Sometimes they fail to take them as prescribed. Failing to take blood pressure lowering drugs can lead to increased chances of stroke. This ‘non-adherence’ to medication can be difficult to measure. New methods recently developed enable detection of blood pressure lowering drugs in an individual’s urine. This approach has revealed non-adherence in patients attending hospital clinics. However, it is unclear to what extent patients in the general population are non-adherent to treatment.  It is also unclear whether patients would be willing to provide a urine sample to test for non-adherence.

Methods

This study will enrol up to 285 people aged at least 65 years old, visiting their GP for a routine check-up. Information describing their age, gender and medical history will be collected. In those who agree, urine samples will be taken and sent to a laboratory at the University Hospitals of Leicester. The samples will be analysed to detect the presence of prescribed blood pressure lowering drugs. This information will be used to understand:

1. The number of patients willing participate in the study and share a urine sample (feasibility aim).
2. Whether people who are willing to participate in this research study are different to those who decline to participate.
3. How many patients are ‘non-adherent’ to blood pressure lowering drugs.
4. Whether there are things about a patient (for example, their age or medical history) which makes them more or less likely to take their prescribed blood pressure lowering drugs.

How will this benefit patients?

The findings of the research will help inform future studies of targeted medication reduction and self-management in multi-morbid patients taking lots of different drugs. If successful, urine spot testing could be added to the annual review process for people with poorly controlled blood pressure in primary care. Being able to identify patients who are not taking their medications as prescribed will enable doctors to have more informed discussions with their patients about the underlying reasons for non-adherence.  This could lead to more personalised care and more effective prevention of cardiovascular disease.