Compliance, quality of life, and cost effectiveness

Abstract

Introduction Fewer than a half of people in the United States with high blood pressure are currently on treatment and of these less than half have their blood pressures controlled to less than 140/90 mm Hg [1]. Similar results have been found in New Zealand, Italy, and Spain [2–4] The limited success in controlling blood pressure stems from multiple factors including uncertainty of patients about the benefits of treatment for this silent disease, failures of patient compliance, adverse effects of medications, less than optimal efforts by physicians to encourage patients to adhere to regimens, and failures of the health-care system to reduce barriers to continued care. This article reviews recent studies on patient compliance and the measurement of the quality of life and then summarizes their implications for the cost-effectiveness of treatment for hypertension. Very few recent clinical trials have directly evaluated interventions to improve patien compliance or have directly examined the effects of treatment on the quality of life in hypertensives. Most available studies are retrospective and either observational or meta-analytic in nature.