Back to Journals » Patient Preference and Adherence » Volume 13

Objective measures of non-adherence in cardiometabolic diseases: a review focused on urine biochemical screening

Authors Lane D, Patel P, Khunti K, Gupta P

Received 14 November 2018

Accepted for publication 16 February 2019

Published 12 April 2019 Volume 2019:13 Pages 537—547

DOI https://doi.org/10.2147/PPA.S162215

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Dr Johnny Chen


Dan Lane,1,2 Prashanth Patel,2,3 Kamlesh Khunti,1 Pankaj Gupta2,3

1Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester, UK; 2Department of Chemical Pathology and Metabolic Diseases, Leicester Royal Infirmary, Leicester, UK; 3Department of Cardiovascular Sciences, University of Leicester, Leicester, UK

Abstract: Cardiometabolic diseases are among the most prevalent and harmful conditions worldwide. They are complex, comorbid conditions that require polypharmacy – a known contributor to non-adherence in cardiovascular disease (CVD) and diabetes mellitus (DM). Suboptimal adherence is associated with poor disease control, which increases the risk of hospitalizations, mortality, and preventable financial implications. However, until recently, the lack of a gold standard for non-adherence testing in cardiometabolic diseases has been the major barrier for understanding true prevalence and mortality consequences. Recent European guidelines have endorsed biochemical testing as the preferred measure for non-adherence in CVD, with urinary screening methods being the most clinically widespread. The diagnostic and therapeutic benefits incurred to health service resources by use of biochemical non-adherence testing are vast, as hospitalizations and associated economic burdens are reduced, and tailored therapies are increased. However, biochemical testing can only signify a snap shot of adherence behavior, and true adherence may be skewed by pharmacokinetic factors. This review summarizes current literature regarding the prevalence, impact, and reasons of non-adherence in cardiometabolic disease. The benefits of current adherence diagnostic tools have been appraised, where urine in biochemical testing has been focused upon and evaluated against other matrices.

Keywords: adherence, biochemical test, cardiovascular disease, diabetes mellitus, LC-MS/MS


Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]