Treatment Discontinuation or Interruption in Pulmonary Arterial Hypertension

Abstract

Pulmonary arterial hypertension (PAH) is a progressive disease, which can be potentially fatal. The management of a complex disease like PAH requires a multidisciplinary approach from a team consisting of physicians, nurses, social workers, and pharmacists. Adherence to PAH-specific therapy is one of the key factors in the management of this disease. Poor adherence to treatment is a common problem in PAH as it is in many chronic diseases. Management of medication interruptions is a challenge in patients with PAH that can lead to negative consequences. However, for most PAH-specific drugs, there are no clear guidelines on how to manage temporary or abrupt medication discontinuations. In this review, we summarized the available literature and provide suggestions on how to manage interruptions of PAH-specific therapies.

Adherence to disease-specific drug treatment among patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension

“…In addition, previous experiences with pharmacological therapies might lead to a lack of motivation to adhere to a treatment [17]. Thus, it is important to address the patients concerns about a treatment, both at the time of first prescription as well as at subsequent meetings with the patient [18,19]. As shown in the present study, as well as in earlier studies, the longer time since diagnosis that has elapsed, the lower is the adherence to treatment [7,8].…”

“…Chronic treatment (≥3 filled prescriptions/year) Angiotensin converting enzyme inhibitors 108 (19) 81 2127 (14) Angiotensin-receptor blockers 101 (18) 65 (17) 36 (19) Beta Asthmainhaler therapy 171 (30) 119 (31) 52 (28) Anti-diarrheal drugs 79 (14) 62 (16) 17 (9) Anti-emetics 61 (11) 52 (14) 9 (5) Anti-acid drugs 47 (8) 41 (11) 6 (3)…”

Perillyle alcohol and Quercetin ameliorate monocrotaline-induced pulmonary artery hypertension in rats through PARP1-mediated miR-204 down-regulation and its downstream pathway

“…Despite many efforts to understand and treat PAH, there is still no definite cure for it, and most vascular dilator therapies have not led to full recovery, with patients dying in less than a decade depending on the severity of the disease [3]. Therefore efforts are ongoing to understand the molecular pathways and mechanisms involved in the pathophysiology of PAH and finding more effective therapies.…”

Understanding the current status of patients with pulmonary hypertension during COVID‐19 outbreak: a small‐scale national survey from China

“…An interruption of treatment around three days might be tolerated, 19 but clinical worsening might happen due to the discontinuation of medications. 20 Patients preferred clinic visiting to consult doctors for any modification. Our patients showed higher desire to contact their doctors even though we had provided online consultation before the survey.…”