{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T11:37:21Z","timestamp":1776685041855,"version":"3.51.2"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T00:00:00Z","timestamp":1648166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Many challenges exist in determining true rates of adherence to antihypertensive medications among individuals in a clinic setting. For the first time, we aimed to compare patient\u2010reported antihypertensive adherence with objective evidence using mass spectrometry spot urinalysis in a tertiary referral clinic setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective observational single\u2010centre cohort study was performed in a tertiary referral hypertension clinic, encompassing antihypertensive initiation and persistence. Patients were referred with apparent treatment\u2010resistant hypertension or for suspected secondary causes. Participants completed a self\u2010reported assessment of antihypertensive adherence and provided a spot urine sample. The presence of antihypertensive medications and\/or their respective metabolites was evaluated using high\u2010performance liquid chromatography tandem mass spectrometry. Patients were determined to be adherent if they demonstrated both self\u2010reported adherence and objective mass spectrometry evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of all 105 eligible participants initially recruited, 73 (69.5%) met the eligibility criteria. Only 27.4% (95% confidence interval 0.2\u20100.4) of participants demonstrated true adherence to their self\u2010reported antihypertensives, despite 75.3% (0.6\u20100.8) reporting adherence. Greatest medication adherence was achieved with angiotensin II receptor blockers (61%), with calcium\u2010channel blockers and mineralocorticoid antagonists demonstrating least adherence (38%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients attending a tertiary hypertension clinic, the combined use of spot urine mass spectrometry and self\u2010reporting identifies higher rates of nonadherence when compared to either modality alone. Both techniques should be combined for more accurate detection of medication adherence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.15292","type":"journal-article","created":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T02:56:09Z","timestamp":1645671369000},"page":"1948-1955","source":"Crossref","is-referenced-by-count":14,"title":["Major disparities in patient\u2010reported adherence compared to objective assessment of adherence using mass spectrometry: A prospective study in a tertiary\u2010referral hypertension clinic"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6414-9803","authenticated-orcid":false,"given":"James M. 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