This showed a promising sign that it may improve medication adherence.
The findings highlight the challenges of tackling hidden non‑adherence, a problem that affects up to one in three people with high blood pressure and costs the NHS millions of pounds in unnecessary tests and treatments.
The authors argue that larger trials are urgently needed to understand whether CAT‑based interventions could play a role in improving long‑term outcomes for people with hypertension.
They also add that the technology may yet prove valuable as part of a personalised approach to managing chronic conditions where missing medications is common.
The Chief Investigator of OUTREACH is Maciej Tomaszewski, Professor of Cardiovascular Medicine at The University of Manchester and Honorary Consultant Physician at Manchester University NHS Foundation Trust.
He is also Integrative Cardiovascular Medicine Co-Theme Lead at the National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre (BRC), which partly supported the research.
He said: “Sharing the results of the CAT with the patients and the discussion for the reasons behind missing their blood pressure lowering medications appears to help in improving adherence.
While there was a trend for this improved adherence to favour lower blood pressure, we could not detect a statistically significant signal in blood pressure.
Hidden non‑adherence remains a major and costly problem in hypertension care, and our findings underline the need for larger, longer‑term trials to understand where CAT‑based approaches might still add value.”
Professor Bryan Williams, Chief Scientific and Medical Officer at the British Heart Foundation and senior author on the study, said: “High blood pressure is the leading modifiable risk factor for cardiovascular disease in the UK, where it is associated with 50 per cent of heart attacks and strokes. This means it is crucial that people take medications to treat it as advised by their doctor.
“We hope that this personalised approach to monitoring adherence can help address the many reasons why people may not be taking their medication properly, and support them to do so in future. This study showed signs that this strategy may help improve adherence, but to properly judge its effectiveness, a larger study is needed.”
- The paper: Chemical adherence testing-guided intervention versus standard of care in patients with hypertension who are non-adherent to antihypertensive treatment in the UK (OUTREACH): a multicentre, randomised controlled trial is available here. DOI
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