Chemical Adherence Testing was perceived by 9 clinicians as a valuable tool for detecting non-adherence, despite concerns about logistical barriers, costs, and potential strain on patient trust.
Clinicians view chemical adherence testing as a promising objective tool for hypertension management, but highlight significant logistical, ethical, and relational barriers to its routine implementation.
Abstract Aims Chemical Adherence Testing (CAT) is gaining prominence as a reliable and valid clinical method to detect whether antihypertensive agents are being taken as prescribed. This study aimed to explore clinicians' attitudes and perspectives on the clinical use of CAT. Methods Clinicians involved in hypertension care were recruited through purposive and snowball sampling (N = 9). Participants represented general practice, cardiology, geriatric medicine, clinical pharmacology, nephrology and internal medicine. Semi‐structured interviews were carried out, and transcripts were analysed using reflexive thematic analysis with an inductive, constructivist approach. Theme development was peer‐reviewed by a health psychologist and clinical pharmacologist to enhance reflexivity. Results Three themes were developed: (1) The impactful weight of new evidence ‐ CAT was perceived as a valuable, more objective tool for checking for non‐adherence and informing treatment, especially in cases of suspected treatment‐resistant hypertension; (2) CAT meets clinical reality ‐ participants highlighted practical barriers such as test availability, workflow disruption, staffing needs and costs that could impact implementation in an overburdened healthcare system; (3) The human side of CAT ‐ while CAT supported discussions around adherence, clinicians highlighted the need for trust, consent and sensitive communication to avoid perceptions of policing or blame. Conclusion Clinicians viewed CAT as a promising tool for improving diagnostic clarity and prompting adherence discussions. However, concerns about logistical feasibility, ethical use and potential strain on patient relationships were evident. Successful implementation requires clinician training, clear communication and system‐level support to ensure CAT is integrated in an ethical, patient‐centred way that preserves trust and supports collaborative care.
Shahab et al. (2026) studied hypertension (n=9). Chemical Adherence Testing (CAT) was evaluated on Clinicians' attitudes and perspectives on the clinical use of CAT. Chemical Adherence Testing was perceived by 9 clinicians as a valuable tool for detecting non-adherence, despite concerns about logistical barriers, costs, and potential strain on patient trust.