Evidence-based approaches to improve antihypertensive medication adherence

Abstract

Background Hypertension is a major public health concern all over the world and a consistent and independent risk factor for cardiovascular, kidney diseases and stroke. The prevalence of hypertension is high in both developing and developed countries. Moreover, poor antihypertensive medication adherence leads to difficult blood pressure control. I therefore conducted a systematic review of evidenced-based approaches to improve medication adherence. Aim To evaluate the effectiveness of evidence-based approaches in terms of antihypertensive medication adherence and also discuss the strengths and limitations of each method. Methods Conducted a systematic review of published literature on methods to improve antihypertensive medication adherence in Web of Science and PubMed in May 2015. Search strategy covered the years 2000 to 2015 and included articles in English. Results 43studies met the inclusion criteria. The interventions were divided into five categories: patient education; healthcare provider education and interventions; social support; self-monitoring and self-report and dosing regimes. Of these interventions, approaches involving healthcare providers, in particular clinical pharmacists were effective strategy to increase medication adherence. Conclusion Interventions that involved healthcare provider were effective in improving antihypertensive medication adherence. Further studies with experimental evidence would be useful. Evidence-based approaches identified may have implications on public health and clinical practice as well as health service planning.