Impact of Interventions on Medication Adherence and Blood Pressure Control in Patients with Essential Hypertension: A Systematic Review by the ISPOR Medication Adherence and Persistence Special Interest Group
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Objectives To systematically review the evidence on the impact of interventions to improve medication adherence in adults prescribed antihypertensive medications.Methods An electronic search was undertaken of articles published between 1979 and 2009, without language restriction, that focused on interventions to improve antihypertensive medication adherence among patients (≥18 years) with essential hypertension. Studies must have measured adherence as an outcome of the intervention. We followed standard guidelines for the conduct and reporting of the review and conducted a narrative synthesis of reported data.Results Ninety-seven articles were identified for inclusion; 35 (35 of 97, 36.1%) examined interventions to directly improve medication adherence, and the majority (58 of 97, 59.8%) were randomized controlled trials. Thirty-four (34 of 97, 35.1%) studies reported a statistically significant improvement in medication adherence.Discussion/conclusions Interventions aimed at improving patients' knowledge of medications possess the greatest potential clinical value in improving adherence with antihypertensive therapy. However, we identified several limitations of these studies, and advise future researchers to focus on using validated adherence measures, well-designed randomized controlled trials with relevant adherence and clinical outcomes, and guidelines on the appropriate design and analysis of adherence research.
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Only 1 in 5 patients has sufficiently high adherence to achieve the benefits observed in clinical trials.
“During the first year of treatment, the average patient has possession of antihypertensive medications only 50% of the time, and only 1 in 5 patients has sufficiently high adherence to achieve the benefits observed in clinical trials.98,99”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [98]
During the first year of treatment, the average patient has possession of antihypertensive medications only 50% of the time.
“During the first year of treatment, the average patient has possession of antihypertensive medications only 50% of the time, and only 1 in 5 patients has sufficiently high adherence to achieve the benefits observed in clinical trials.98,99”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [98]
A quarter of patients who are newly initiated on antihypertensive therapy fail to fill their initial prescription.
“However, a quarter of patients who are newly initiated on antihypertensive therapy fail to fill their initial prescription.97,98”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [98]
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- Authors
- Gwadry-Sridhar, F. H., Manias, E., Lal, L., Salas, M., Hughes, D. A., Ratzki-Leewing, A., & Grubisic, M.
- Affiliations
- Western University (CA)
- The University of Melbourne (AU)
- AstraZeneca (United States) (US)
- Bangor University (GB)
- Corresponding author
- Gwadry-Sridhar, Femida H.
- Venue
- Value in Health
- Publisher
- Elsevier BV
- Published
- 2013-07
- Volume
- 16
- Issue
- 5
- Pages
- 863-871
- ISSN
- 1098-3015 (ISSN-L)
- OpenAlex
- W2042085280
- Cited by
- 155
- References
- 147
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 8 · 2023: 9 · 2022: 7 · 2021: 20 · 2020: 18 · 2019: 17 · 2018: 24 · 2017: 12 · 2016: 12 · 2015: 16 · 2014: 4 · 2013: 1
- FWCI
- 1.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Value in Health (publishedVersion)
- PubMed (publishedVersion)
- Deakin Research Online (Deakin University) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Keywords
- medication adherence, essential hypertension, antihypertensive therapy, adherence interventions, blood pressure control, medication knowledge, adherence measurement
- MeSH terms
- Essential Hypertension, Antihypertensive Agents, Blood Pressure, Humans, Hypertension, Health Knowledge, Attitudes, Practice, Patient Education as Topic, Reminder Systems, Medication Adherence
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