title: Methods to improve medication adherence in patients with hypertension: current status and future directions.
abstract: 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.
authors.affiliation: Department of Clinical Outcomes Research, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USA. mawood@ochsner.org
authors.forename: Marie
authors.initials: M
authors.lastname: Krousel-Wood
authors.forename: Amanda
authors.initials: A
authors.lastname: Hyre
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Donald
authors.initials: D
authors.lastname: Morisky
mesh_terms: 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
chemical_list: D000959:Antihypertensive Agents