e16 Journal of Hypertension Vol 35, e-Supplement 2, September 2017
drugs; meanwhile, polytherapy often results in poor therapeutic adherence, classi-
fied as “pseudo-resistant’’ hypertension. In this context, Therapeutic Drug Moni-
toring (TDM) of antihypertensive drugs, which consists in the measurement of
drug concentration in biological matrices, may help to discern problems in drug
pharmacokinetics/pharmacodynamics from cases of poor therapeutic adherence,
also considering that not-pharmacological alternative consists in invasive surgery.
It has been hence validated an UHPLC-MS/MS method for simultaneous TDM
on plasma samples of ten antihypertensive drugs: amlodipine, atenolol, clonidine,
chlortalidone, doxazosin, hydrochlorothiazide, nifedipine, olmesartan, ramipril
and telmisartan.
Design and method: This method has been validated according to FDA guide-
lines. 200 ml of sample, standard and quality control, added with 40 ml of internal
standard working solution, undergo a simple protein precipitation protocol, fol-
lowed by drying step, and resulting extracts are resuspended in water:acetonitrile
90:10 (v:v; +0.05% formic acid) and then analyzed through a Shimadzu Nex-
eraX2® UHPLC system coupled with a LCMS-8050® tandem mass detector. The
validated method was tested on real samples from patients with RH/pseudo-RH,
all giving informed consent.
Results: All analytical parameters of the method fitted FDA guidelines for all the
analytes. 42 patients have been enrolled (SEAL study). TDM revealed that 55% of
patients (n = 23) had detectable concentration of all prescribed drugs (considered
fully adherent), 26% (n = 11) resulted partially non-adherent (only part of the pre-
scribed drugs was detectable) and 19% (n = 8) were totally not-adherent (no drugs
were detected). Through univariate/multivariate logistic regression, the diastolic
pressure and the “white-coat’’ increase in heart rate resulted the best predictors of
poor adherence. Through ROC curve analysis a diastolic pressure over 124 mmHg
resulted predictive of total inadherence.
Conclusions: TDM can be a gold-standard for evaluating therapeutic adherence and
this method results eligible for a clinical routine use. We managed to discern cases
of inadherence, preserving some patients from an invasive and expensive surgery.
OP.2B.05 EFFECT OF HEALTH EDUCATION INTERVENTION
ON IMPROVING COMPLIANCE TO TREATMENT
AMONG HYPERTENSIVE PATIENTS: APPLICATION
OF HEALTH BELIEF MODEL
W. Khalil, M. Tartour. Zagazig, University of Zagazig, Egypt
Objective: The Health Belief Model is trusted that a patient who feels susceptible
to hypertension and its complication is more likely to abide to treatment as op-
posed to the subject who doesn’t belief this idea. Objectives: to determine level
of participants’ knowledge about hypertension. Then to assess factors affecting
treatment compliance with antihypertensive treatment guided by the use of Health
Belief Model variables among hypertensive patients. Finally evaluate the effec-
tiveness of using health education applying HBM on knowledge and compliance
to treatment.
Design and method: An intervention study was carried out using two groups.
The two groups include: The health belief model Group: received educational
intervention sessions based on the HBM conceptual framework, Comparison
Group: received the traditional health education on knowledge about hyperten-
sion and compliance to medication and life style regimen. The target groupwas
hypertensive patients in the hypertension clinic at Zagazig University Hospital.
All patients attending the clinic over one month were included in the study as a
comprehensive sample
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
Results: Marked improvement in the HBM group in overall compliance (61.3%
to 79.6%) in contrast to the ordinary health education group no marked improve-
ment. the percentages of Perceived susceptibility, Perceived severity, Perceived
benefits, Perceived barriers, self efficacy cues to action show changes between pre
test and post test results with a statistical difference in HBM group. For control
group comparing pretest and post test results was of no significant difference ex-
cept for Perceived severity, Perceived benefits, and self efficacy.
Conclusions: The findings support the hypothesis that using health education
based on HBM has better results in adherence to treatment than traditional health
education.
OP.2B.06 CONTROL OF HYPERTENSION AMONG THE
FACULTY OF SAINT-PETERSBURG UNIVERSITIES
O. Rotar, A. Alieva, A. Orlov, M. Boyarinova, E. Moguchaia, A. Gurevich,
A. Erina, V. Solntsev, A. Konradi, V. Shlyakhto. Almazov North-West Federal Med-
ical Research Centre, Saint-Petersburg, Russia
Objective: The aim of the study was to assess awareness about BP level and com-
pliance with antihypertensive drugs in the faculty members of Saint-Petersburg
universities. This subpopulation is well-educated and can affect lifestyle attitudes
of students.
Design and method: 747 professors from 22 to 80 years old were screened
at their working places in 6 St.Petersburg Universities in October-December of
2016. The informed consent was obtained from all participants. Information on
antihypertensive medication was collected. All subjects were interviewed with
special questionnaire, which included personal data, life style risk factors, and
medical history. Blood pressure (BP) was measured on right arm in the sitting
position after 5-minute rest by automatic tonometer OMRON (Japan).
Results: Table 1 Prevalence of HTN and complaince.
Conclusions: The prevalence of hypertension is high, especially in males despite
general predominance of females in university faculty staff. Males have worse
hypertension awareness and poor compliance to antihypertensive drugs. Control
of hypertension is poor independently of gender in spite of good intellectual level.
OP.2B.07 ASSESSMENT OF DRUG ADHERENCE AND
PSYCHOLOGICAL PROFILE IN PATIENTS
WITH APPARENTLY TREATMENT-RESISTANT
HYPERTENSION
C. Georges1,2, E. Berra1,3, A. Capron2,4, G. Petit5, P. De Timary5, P. Wallemacq2,4,
A. Persu1,6. 1Department of Cardiology, Cliniques Universitaires Saint-Luc,
Université Catholique de Louvain, Brussels, Belgium, 2Clinical Chemistry
Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium,
3Department of Medical Sciences, Internal Medicine and Hypertension
Division, AOU Città della Salute e della Scienza, Turin, Italy, 4Louvain Center
for Toxicology and Applied Pharmacology, Université Catholique de Louvain,
Brussels, Belgium, 5Adult Psychiatry Department and Institute of Neuroscience,
Cliniques Universitaires Saint-Luc, Brussels, Belgium, 6Pole of Cardiovas-
cular Research, Institut de Recherche Expérimentale et Clinique, Université
Catholique de Louvain, Brussels, Belgium
Objective: Recent studies using drug monitoring suggest that a high proportion
of patients with apparently treatment-resistant hypertension (aTRH) are in fact
poorly or non-adherent. However, in most cases, antihypertensive treatment was
not standardized, and predictive factors of poor adherence were not analyzed. The
aim of this work was to assess adherence in patients with aTRH on a standardized
treatment, and to identify predictive factors of poor adherence, including psycho-
logical profile (emotion regulation, psychopathology and traumatic events).
Design and method: All patients with confirmed aTRH on a treatment regi-
men including Olmesartan, Amlodipine, Hydrochlorothiazide and Spironolac-
tone were eligible. Drug adherence was assessed by the Morisky Medication
Adherence Scale (MMAS-8) and drug dosages in urine using Liquid Chroma-
tography-Mass Spectrometry (LC-MS/MS). Psychological profile was assessed
by the Toronto Alexithymia Scale (TAS 20), the Multidimensional Experiential