Research Rooted in Care

Doctors treating hypertension occasionally find themselves in a tricky situation: when patients say they are taking their medication, but blood pressure remains high, should physicians increase medication dosage or investigate adherence? Either choice carries risk – increase medication dosage and risk dangerous blood pressure drops if the patient becomes compliant or leave dosage unchanged and risk long-term health complications if the condition is not managed.

It is exactly this clinical dilemma that sparked an innovative partnership between Endocrinology Head and Senior Consultant Clin Asst Prof Troy Puar and Consultant Dr Sumitro Harjanto.

When Dr Troy began developing his research approach for hypertension medication adherence, he drew inspiration from studies conducted in the United Kingdom. Recognising the potential to adapt the studies to improve patient outcomes locally, Dr Troy knew he needed the right people on board – and soon found Dr Sumitro to be a perfect fit. Dr Sumitro brought what the project demanded: an inquisitive mind that thrived on complex problems, and a keen interest in research and innovation projects.

“When Dr Troy shared his vision for the project and its potential to improve hypertension testing and treatment, I felt that I could believe in it. And that’s important, because if you share the same vision, you can run together.”

– Dr Sumitro Harjanto,
Consultant, Endocrinology

It was this alignment of purpose that would prove crucial when the project faced its first hurdle. Patient recruitment had slowed, as hypertensive patients at the clinic had their condition under control, making them ineligible for the study.

Turning to Dr Troy for guidance, his mentor’s response demonstrated his collaborative approach, reaching out to colleagues from other departments. Within days, he secured buy-in from the Cardiology and Internal Medicine teams, opening up new patient pools for recruitment.

This reflects Dr Troy’s conviction in the power of partnership – for him, research success depends on leveraging different perspectives.

“I want to make sure that the next person that comes into our hospital receives better treatment. We learn from every patient we see, and sharing these insights through research is even more valuable – it means that beyond each individual, everyone can collectively benefit from that knowledge.”

– Clin Asst Prof Troy Puar,
Head and Senior Consultant, Endocrinology

And whether in medical research or clinical care, both doctors share a common belief: that ultimately, the aim is to focus on what helps the patient.

“We need to see each patient as a unique individual. I value what the patient thinks about their condition and what they see as important to them, then design their treatment around that.”

– Dr Sumitro Harjanto,
Consultant, Endocrinology

“Collaboration is key. I learn something from everyone who works with me on projects because each person has something of value to add, whether they are students, nurses or coordinators.”

– Clin Asst Prof Troy Puar,
Head and Senior Consultant, Endocrinology

It was this common belief and passion for research to uncover new knowledge and improve healthcare that led them to carry out Adherence Testing Using Urine Mass Spectrometry (ADURINE) in Singapore. Leveraging mass spectrometry to detect medication compounds in urine samples, the technology provides objective evidence of whether patients are actually taking their prescribed medications.

Dr Sumitro explains how this transforms patient interactions, "We can have frank conversations with patients – 'Aunty, you haven't been taking the medication, right? Can you tell me why? Is it because this medicine is giving you problems?' Then we can explore solutions – combination tablets, different dosages, addressing specific concerns."

This represents a fundamental shift to medication non-adherence, enabling honest, supportive discussions that address real barriers to treatment compliance.

It is exactly this kind of meaningful change that drives their research forward. As their ADURINE research continues to gather data, both doctors remain focused on the ultimate goal: bridging the gap between clinical challenges and innovative solutions and turning difficult conversations into opportunities for genuine partnership with patients – one honest conversation at a time.

Learn more about Dr Sumitro's journey and what inspires him here.