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Abstract
Despite increased awareness, poor adherence to treatments for chronic diseases remains a global problem. Adherence issues are common in patients taking antihypertensive therapy and associated with increased risks of coronary and cerebrovascular events. Whilst there has been a gradual trend toward improved control of hypertension, the number of patients with blood pressure values above goal has remained constant. This has both personal and economic consequences. Medication adherence is a multifaceted issue and consists of three components: initiation, implementation, and persistence. A combination of methods is recommended to measure adherence, with electronic monitoring and drug measurement being the most accurate. Pill burden, resulting from free combinations of blood pressure lowering treatments, makes the daily routine of medication taking complex, which can be a barrier to optimal adherence. Single-pill fixed-dose combinations simplify the habit of medication taking and improve medication adherence. Re-packing of medication is also being utilized as a method of improving adherence. This paper presents the outcomes of discussions by a European group of experts on the current situation of medication adherence in hypertension.
Highlights
Poor adherence to treatments for chronic diseases is a worldwide problem and was highlighted as a problem of striking magnitude by the World Health Organization [WHO] (2003)
Adherence is of particular concern in hypertension, with about half of the patients prescribed an antihypertensive drug stopping taking it within 1 year, in a longitudinal study of electronically compiled dosing histories of 4783 patients (Vrijens et al, 2008)
Medication adherence can be defined as the process by which patients takes their medications as prescribed (Vrijens et al, 2012) and is a dynamic process that changes over time
Summary
Poor adherence to treatments for chronic diseases is a worldwide problem and was highlighted as a problem of striking magnitude by the World Health Organization [WHO] (2003). Adherence is of particular concern in hypertension, with about half of the patients prescribed an antihypertensive drug stopping taking it within 1 year, in a longitudinal study of electronically compiled dosing histories of 4783 patients (Vrijens et al, 2008). Medication adherence can be defined as the process by which patients takes their medications as prescribed (Vrijens et al, 2012) and is a dynamic process that changes over time.
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