Recent studies from our group and others using
therapeutic drug monitoring (TDM) indicate that nonadherence to antihypertensive medications occurs in up to 60% of patients who appear to have TRH. In the United States and many other countries, TDM assays to assess serum levels of most antihypertensive drugs are now available in clinical practice and are covered by most health care payers. When used as a tool to identify barriers to adherence and improve patients’ pilltaking behavior, TDM was found to be cost-effective in the management of TRH.11 However, the relationship between the prevalence of PA and medication adherence as confirmed by TDM has not been previously assessed.
Furthermore, the cost-effectiveness of a TDM-guided
approach to the diagnosis of PA is unknown.