Effectiveness and content analysis of interventions to enhance medication adherence in hypertension: a systematic review and meta-analysis protocol.
BACKGROUND
Hypertension control through pharmacological treatment has led to substantial benefits in the prevention of morbidity and mortality from cardiovascular diseases. However, evidence from a number of studies suggests that as many as 50 to 80 % of patients treated for hypertension have low adherence to their treatment regimen. The objective of this systematic review is to evaluate the effectiveness of medication adherence interventions for hypertension. In addition, we aim to explore what barriers and facilitators in the interventions may have been targeted and how these might be related to the effect size on blood pressure (BP).


METHODS
This review is a hypertension-specific update to the previous Cochrane Review by Nieuwlaat et al. (2014) on interventions to enhance medication adherence. A systematic literature search will be carried out, and two authors will independently screen titles and abstracts for their eligibility for inclusion and independently extract data from the selected studies and assess the methodological quality using the Cochrane Collaboration Risk of Bias Tool. A meta-analysis will be conducted, and additionally, theoretical factors in interventions will be identified using the Theoretical Domains Framework.


CONCLUSIONS
This review will generate new information by quantitatively evaluating the effectiveness of adherence interventions for hypertension and potentially identify which theoretical domains are associated with more effective interventions and which domains have not been the subject of intervention development.


BACKGROUND
PROSPERO CRD42016033358.
School of Psychology, National University of Ireland, Galway, Ireland. e.morrissey6@nuigalway.ie.
Eimear C
EC
Morrissey
School of Psychology, National University of Ireland, Galway, Ireland.
Hannah
H
Durand
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Robby
R
Nieuwlaat
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Tamara
T
Navarro
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
R Brian
RB
Haynes
School of Psychology, National University of Ireland, Galway, Ireland.
Jane C
JC
Walsh
School of Psychology, National University of Ireland, Galway, Ireland.
Gerard J
GJ
Molloy
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001795:Blood Pressure Determination; D004338:Drug Combinations; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D055118:Medication Adherence; D010353:Patient Education as Topic; D012648:Self Care; D000078202:Systematic Reviews as Topic; D015201:Meta-Analysis as Topic
D000959:Antihypertensive Agents; D004338:Drug Combinations
Blood pressure; Compliance; Hypertension; Medication adherence