Use of strategies to improve antihypertensive medication adherence within United States outpatient health care practices, DocStyles 2015-2016

J Clin Hypertens (Greenwich). 2018 Feb;20(2):225-232. doi: 10.1111/jch.13188. Epub 2018 Feb 4.

Abstract

Patients' adherence to antihypertensive medications is key to controlling high blood pressure. Evidence-based strategies to improve adherence exist, but their use, individually and in combination, has not been described. 2015-2016 DocStyles data were analyzed to describe health care professionals' and their practices' use of 10 strategies to improve antihypertensive medication adherence across 3 categories: prescribing, education, and tracking/encouragement. Among 1590 respondents, a mean of using 5 strategies was reported, with individual strategy use ranging from 17.2% (providing patients adherence-related rewards) to 69.4% (prescribing once-daily regimens). Those with higher odds of using ≥7 strategies and strategies across all 3 categories included: (1) nurse practitioners compared to family practitioners/internists and (2) health care professionals in practices with standardized hypertension treatment protocols who routinely recommend home blood pressure monitor use compared to respondents without those characteristics. Despite using an array of evidence-based adherence-promoting strategies, additional opportunities exist for health care professionals to provide adherence support among hypertensive patients.

Keywords: adherence; antihypertensive therapy; clinical management of high blood pressure; hypertension-general.

MeSH terms

  • Antihypertensive Agents / therapeutic use*
  • Assessment of Medication Adherence*
  • Attitude of Health Personnel
  • Blood Pressure Monitoring, Ambulatory / methods
  • Evidence-Based Practice / methods
  • Evidence-Based Practice / standards
  • Female
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / drug therapy
  • Hypertension* / epidemiology
  • Male
  • Nurse Practitioners*
  • Outpatients / statistics & numerical data
  • Patient Preference / statistics & numerical data
  • Physicians, Family*
  • Practice Patterns, Physicians'* / standards
  • Practice Patterns, Physicians'* / statistics & numerical data
  • Quality Improvement
  • Surveys and Questionnaires
  • United States / epidemiology

Substances

  • Antihypertensive Agents