Title: Medication non-adherence as a critical factor in the management of presumed resistant hypertension: a narrative review
Authors: De Geest, Sabina ×
Ruppar, Todd
Berben, Lut
Schönfeld, Sandra
Hill, Martha N #
Issue Date: Jan-2014
Series Title: EuroIntervention vol:9 issue:9 pages:1102-9
Article number: 10.4244/EIJV9I9A185
Abstract: Aims: Medication non-adherence is a crucial behavioural risk factor in hypertension management. Forty-three to 65.5% of patients with presumed resistant hypertension are non-adherent. This narrative review focuses on the definition of adherence/non-adherence, measurement of medication adherence, and the management of medication non-adherence in resistant hypertension using multilevel intervention approaches to prevent or remediate non-adherence. Methods and results: A review of adherence and resistant hypertension literature was conducted. Medication adherence consists of three different yet related dimensions: initiation, implementation, and discontinuation. To effectively measure medication non-adherence, a combination of direct and indirect methods is optimal. Interventions to tackle medication non-adherence must be integrated in multilevel approaches. Interventions at the patient level can combine educational/cognitive (e.g., patient education), behavioural/counselling (e.g., reducing complexity, cueing, tailoring to patient's lifestyle) and psychological/affective (e.g., social support) approaches. Improving provider competencies (e.g., reducing regimen complexity), implementing new care models inspired by principles of chronic illness management, and interventions at the healthcare system level can be combined. Conclusions: Improvement of patient outcomes in presumed resistant hypertension will only be possible if the behavioural dimensions of patient management are fully integrated at all levels.
ISSN: 1774-024X
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Academic Centre for Nursing and Midwifery
× corresponding author
# (joint) last author

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