Consistent adherence to pulmonary hypertension-specific oral therapy significantly improves clinical outcomes, according to a new prospective study evaluating patients with pulmonary arterial hypertension (PAH) and distal chronic thromboembolic pulmonary hypertension (CTEPH).
These two conditions are progressive, life-limiting diseases where timely, consistent medication use is critical to stabilise symptoms and prolong survival. Previous research has highlighted suboptimal adherence rates in this population, yet detailed real-world evaluations have been lacking.
Recognising that poor medication adherence can increase hospitalisation rates and worsen prognosis for chronic diseases in general, this study aimed to provide robust data on adherence rates and their clinical consequences for this patient group.
The Swiss research team prospectively followed 93 patients (66% women; mean age 57 years) treated with pulmonary hypertension-targeted oral therapies between 2013 and 2023.
Medication adherence was assessed using pharmacy refill records and self-reported questionnaires, with adherence defined as greater than or equal to 80%. Patients’ clinical status was monitored over time using a simplified four-strata risk assessment model.
PAH and medication adherence on outcomes
Overall, 78% of patients were classified as adherent and showed improvement across all risk parameters. In contrast, non-adherent patients showed limited clinical gains. Patients with adverse drug reactions were 75% more likely to be non-adherent, while older age and higher baseline disease severity were associated with better adherence.
As noted by the authors, ‘insufficient adherence and potential contributing factors should be regularly considered, especially in patients without improvement after starting disease-specific therapy.’
As demonstrated by this study, sustained medication adherence is crucial for achieving clinical improvements in PAH and CTEPH. Proactive identification of patients at risk of poor adherence and early management of side effects could improve outcomes in this cohort and would be suitable for future research projects in this disease area.
Reference Reimann L et al. Medication adherence and clinical outcome in patients with pulmonary arterial hypertension or distal chronic thromboembolic pulmonary hypertension. BMJ Open Respir Res. 2025;12:e003023.
This article was originally published by our sister publication Hospital Pharmacy Europe.
