Strategies for Adherence to Treatments for Hypertension
Strategies for Adherence to Treatments for Hypertension
Dan W. Jones, MD, past-president of the American Heart Association, and Paul Whelton, MD, chair of the writing group for the 2017 Hypertension Clinical Practice Guidelines discuss strategies for adherence to treatments for hypertension.
Content
5.569 -> hello i'm dr. dan jones past president
9.179 -> of the American Heart Association a
10.86 -> professor of medicine and physiology at
13.44 -> the University of Mississippi Medical
14.67 -> Center with me today is dr. Paul Welton
17.64 -> chair of our new accha guidelines for
21.18 -> the management of high blood pressure
22.74 -> dr. Welton previously was CEO and
27.57 -> president of Loyola University Medical
29.91 -> Center in Chicago presently his
32.34 -> professor of global health in the School
34.44 -> of Public Health and the School of
35.969 -> Medicine at Tulane University doctor
38.1 -> welcome thank you for being with us
39.21 -> thank you let's talk a little bit about
42 -> how we implement these new guidelines
43.5 -> that we have so we have some patients
46.95 -> who are being recommended for treatment
49.35 -> that we've not treated before lifestyle
51.6 -> or drug therapy and we've had a more
54.87 -> aggressive lowering of blood pressure in
57.09 -> some patients especially older patients
59.73 -> so would you give us some clues on how
61.77 -> the clinician might work toward
63.69 -> implementing these new guidelines so we
66.54 -> know that it's one thing to recommend a
68.67 -> treatment and it's a different thing to
70.35 -> actually implement it and we provide a
73.08 -> lot of suggestions in our guideline as
75.81 -> to how to be effective in implementing
77.97 -> and many of them clinicians will be
80.07 -> familiar with certainly an important one
82.5 -> is adherence we know that many times a
86.84 -> treatment that is recommended isn't
89.159 -> taken and it's not taken effectively
91.68 -> even if it started so always important
94.17 -> to try to work with patients to ensure
97.549 -> they understand the treatment they're
100.29 -> taking the treatment take the time to
102.659 -> have the conversation and simple things
106.229 -> like once a day dosing rather than twice
109.14 -> a day dosing where there's an
111.27 -> appropriate combination so the patient
114.45 -> only has to add one pill especially if
116.46 -> they're an older patient they may be
118.17 -> taking several other pills taking
120.689 -> advantage of the team that works with us
123.21 -> to be a team-based activity that always
126.99 -> helps a great deal so there are a lot of
129.72 -> other suggestions that we have in there
132.18 -> take
132.66 -> advantage of technology we have a lot of
134.76 -> technologies now from the electronic
137.46 -> health record to tattle monitoring
139.95 -> outside the office these are all
142.71 -> strategies that help us to implement the
145.95 -> treatments that we think are beneficial
147.57 -> I want to ask a little bit more about
150.6 -> that team approach medicine is going
153.69 -> through tremendous change these days and
156.3 -> some some of our clinicians like to
159.56 -> control things they like to talk to the
162.6 -> patient's themselves and I have other
164.52 -> people messing with their patients so
166.14 -> there's this idea of team approach to
168.96 -> having pharmacists and nurses and other
171.36 -> folks involved in decision-making in
173.76 -> care of the patients this is their
175.59 -> evidence that this has been official a
177.66 -> strong evidence that it's beneficial and
180.36 -> of course where there's a clinician
182.72 -> who's a physician involved it's a great
185.52 -> help to that physician because they're
188.49 -> busy they've got lots of things to do so
190.95 -> we know from a lot of clinical trials
193.71 -> that others like nurses and pharmacists
196.47 -> can be very effective in management of
199.41 -> high blood pressure so definitely taking
203.37 -> advantage of the team and of course
205.709 -> including the patient as a part of that
208.02 -> team is very important because we not
210.959 -> only want to understand the pressures in
213.42 -> the office but we now recognize that
216.26 -> working with the patient to a have an
218.97 -> understanding of what's happening
219.87 -> outside the office is very helpful to
222.51 -> our decisions to initiate therapy and to
226.32 -> monitor that therapy over time thank you
229.65 -> III think our readers will find as they
232.14 -> read the guidelines that when they get
234.209 -> to this section they'll find more help
236.04 -> about implementation than in previous
238.98 -> guidelines and I encourage everyone to
241.14 -> go to the guidelines and look at this
243.12 -> and take advantage of the good
244.62 -> information that is there the good
246.12 -> evidence-based information
247.92 -> doctor welcome thank you for your
249.69 -> leadership of providing the guidelines
252.18 -> and for the conversation today Thanks
254.07 -> thank you dr. Jones
256.799 -> you
Source: https://www.youtube.com/watch?v=Vbl3ihcc2L8