Methods to improve medication adherence in patients with hypertension: current status and future directions.
OBJECTIVE
Efficacious pharmacologic treatments are available for the management of hypertension, yet only about 50% of patients treated with antihypertensive medications have their blood pressure controlled. A key factor contributing to poor blood pressure control is suboptimal adherence to prescribed therapy. Despite numerous studies conducted over the last 50 years to identify the best method for increasing patient compliance, no single intervention has emerged as superior to the others. This article reviews the effectiveness of methods to improve antihypertensive medication adherence, discusses the effect of drug benefit caps on compliance, and proposes a framework for future clinical and research directions.


RESULTS
Several recent systematic reviews and meta-analyses have attempted to quantify the effectiveness of various methods to improve adherence. As a result of the multiple factors influencing medication adherence, a patient-centered approach that tailors interventions aimed at overcoming barriers to adherence may be necessary.


CONCLUSIONS
Physicians and other health care professionals should consider nonadherence to medication when evaluating a patient with poor blood pressure control. In selecting an intervention to improve compliance to medications, clinicians should consider engaging the patient in an intervention that overcomes patient-specific barriers. Future research should target development of adherence models, which simultaneously examine the effects and interactions of social, psychological, and biologic variables on antihypertensive medication adherence.
Krousel-Wood
Marie
M
Department of Clinical Outcomes Research, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USA. mawood@ochsner.org
Hyre
Amanda
A
Muntner
Paul
P
Morisky
Donald
D
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D005544:Forecasting; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods / Q000639:trends; D012646:Self Administration; D012648:Self Care / Q000379:methods / Q000639:trends
D000959:Antihypertensive Agents