Biopsychosocial determinants of treatment adherence in hypertension

Abstract

Increasing adherence to treatment among patients with hypertension can prevent the complications, decrease mortality and the costs. The aim of the literature review was to identify publications on the biological, psychological and social determinants associated with treatment adherence among patients with arterial hypertension in order to optimize therapeutic strategies. Bibliographic sources were searched in the PubMed, Google Scholar and Hinari databases. The search strategies contained the key words – adherence, hypertension, biopsychosocial. The full text of the studies was evaluated based on the variables – aim, methodology, number of participants and results. 1,232 citations were identified, 34 articles were reviewed in full, 12 articles – included in the review: six systematic reviews and meta-analyses, three narrative reviews one cohort study and two cross-sectional studies. The biological determinants associated with treatment adherence were: age, sex, disease-related factors; psychological determinants: attitude towards illness and treatment, self-efficacy, perception of illness, beliefs about illness and treatment, depression, health awareness; social determinants: family and social support, socio-economic status, monthly income, factors related to medical assistance, education, civil status, place of residence. Adherence to treatment among patients with hypertension can be improved by using single-pill combination, improving the doctor-patient relationship, family and social support, developing therapeutic education programs for patients with hypertension.