Abstract

JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2022. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-047

Physician Preferences for Recommending Renal Denervation to Hypertensive Patients Is Influenced by Patients’ Antihypertensive Medication Nonadherence Due to Medication Side Effects

By Tzung-Dau Wang, Roland E. Schmieder, David E. Kandzari, Ying-Hsiang Lee, Carlos F Haro, Atul Pathak

Presenter

Tzung-Dau Wang

Authors

Tzung-Dau Wang1, Roland E. Schmieder2, David E. Kandzari3, Ying-Hsiang Lee4, Carlos F Haro5, Atul Pathak6

Affiliation

National Taiwan University Hospital, Taiwan1, University Hospital Erlangen, Germany2, Piedmont Heart Institute, USA3, MacKay Memorial Hospital, Taiwan4, Medtronic, USA5, Centre Hospitalier Princesse Grace, Monaco6
View Study Report
TCTAP A-047
Hypertension Therapies and Renal Denervation

Physician Preferences for Recommending Renal Denervation to Hypertensive Patients Is Influenced by Patients’ Antihypertensive Medication Nonadherence Due to Medication Side Effects

Tzung-Dau Wang1, Roland E. Schmieder2, David E. Kandzari3, Ying-Hsiang Lee4, Carlos F Haro5, Atul Pathak6

National Taiwan University Hospital, Taiwan1, University Hospital Erlangen, Germany2, Piedmont Heart Institute, USA3, MacKay Memorial Hospital, Taiwan4, Medtronic, USA5, Centre Hospitalier Princesse Grace, Monaco6

Background

Patient nonadherence to prescribed antihypertensive medications remains a major contributor to the low rate of hypertension control worldwide. Recent studies have shown nonadherence due to antihypertension medication side effects highly influences patient preference toward alternative, interventional strategies to control hypertension. It is unclear what factors influence physician preferences in recommending renal denervation (RDN) as an interventional therapy to control hypertension. Recent consensus reports from the ESH and from SCAI and NKF highlight the importance of a shared decision-making process between the patient and physician to determine strategies for controlling hypertension. This analysis evaluates which reasons for patient nonadherence to prescribed medications most influence physician preferences to recommend RDN.

Methods

General and interventional cardiologists from Europe and the United States completed an online survey that assessed their willingness to recommend RDN to their patients as an interventional therapy to control hypertension. Physicians were asked to score their likelihood to recommend RDN due to medication nonadherence for three different reasons: 1) patient preference to not take medications, 2) medication side effects, and 3) non-specific nonadherence. Surveys followed the highest industry standards from ISO 20252. Results were compared using two-tailed Z-tests.

Results

Two-thirds of the 501 physicians surveyed stated they would recommend RDN for uncontrolled hypertension regardless of the reason for medication nonadherence. Physicians were significantly more likely to recommend RDN due to patient nonadherence from medication side effects compared to patient preference to not take medications and non-specific reasons for nonadherence (p<0.001).

Conclusion

Physicians were most likely to recommend RDN to patients experiencing medication side effects than for other reasons of medication nonadherence. These findings underscore how provider recommendations are influenced by patient preferences in the shared decision-making process between the patient and physician in developing a joint hypertension control strategy.

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