Interventions to Improve Medication Adherence in Hypertensive Patients: Systematic Review and Meta-analysis

  • Vicki S. ConnEmail author
  • Todd M. Ruppar
  • Jo-Ana D. Chase
  • Maithe Enriquez
  • Pamela S. Cooper
Prevention of Hypertension: Public Health Challenges (P Muntner, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Prevention of Hypertension: Public Health Challenges


This systematic review applied meta-analytic procedures to synthesize medication adherence interventions that focus on adults with hypertension. Comprehensive searching located trials with medication adherence behavior outcomes. Study sample, design, intervention characteristics, and outcomes were coded. Random-effects models were used in calculating standardized mean difference effect sizes. Moderator analyses were conducted using meta-analytic analogues of ANOVA and regression to explore associations between effect sizes and sample, design, and intervention characteristics. Effect sizes were calculated for 112 eligible treatment-vs.-control group outcome comparisons of 34,272 subjects. The overall standardized mean difference effect size between treatment and control subjects was 0.300. Exploratory moderator analyses revealed interventions were most effective among female, older, and moderate- or high-income participants. The most promising intervention components were those linking adherence behavior with habits, giving adherence feedback to patients, self-monitoring of blood pressure, using pill boxes and other special packaging, and motivational interviewing. The most effective interventions employed multiple components and were delivered over many days. Future research should strive for minimizing risks of bias common in this literature, especially avoiding self-report adherence measures.


Hypertension Medication adherence Patient compliance Meta-analysis 



The project was supported by Award Numbers 13GRNT16550001 (Conn-principal investigator) from the American Heart Association and R01NR011990 (Conn-principal investigator) from the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the American Heart Association or the National Institutes of Health.

Compliance with Ethical Standards

Conflict of Interest

Drs. Conn and Cooper report grants from American Heart Association and the National Institutes of Health. Drs. Chase, Enriquez, and Ruppar have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    CDC. High blood pressure fact sheet. In: National Center for Chronic Disease Prevention and Health Promotion DfHDaSP, editor.: Centers for Disease Control and Prevention. 2015.Google Scholar
  2. 2.•
    Burnier M. Managing ‘resistance’: is adherence a target for treatment? Curr Opin Nephrol Hypertens. 2014;23:439–43. This paper documents the importance of inadequate medication adherence in resistant hypertension.Google Scholar
  3. 3.
    Christensen A, Osterberg LG, Hansen EH. Electronic monitoring of patient adherence to oral antihypertensive medical treatment: a systematic review. J Hypertens. 2009;27:1540–51.PubMedCrossRefGoogle Scholar
  4. 4.•
    De Geest S, Ruppar T, Berben L, Schonfeld S, Hill MN. Medication non-adherence as a critical factor in the management of presumed resistant hypertension: a narrative review. EuroIntervention. 2014;9:1102–9. This article explains the role of nonadherence to medications in resistant hypertension.Google Scholar
  5. 5.
    Erdine S, Arslan E. Monitoring treatment adherence in hypertension. Curr Hypertens Rep. 2013;15:269–72.PubMedCrossRefGoogle Scholar
  6. 6.
    Simpson SH, Eurich DT, Majumdar SR, Padwal RS, Tsuyuki RT, Varney J, et al. A meta-analysis of the association between adherence to drug therapy and mortality. BMJ. 2006;333:15.PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Wofford MR, Minor DS. Hypertension: issues in control and resistance. Curr Hypertens Rep. 2009;11:323–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Vrijens B, Vincze G, Kristanto P, Urquhart J, Burnier M. Adherence to prescribed antihypertensive drug treatments: longitudinal study of electronically compiled dosing histories. BMJ. 2008;336:1114–7.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Jung O, Gechter JL, Wunder C, Paulke A, Bartel C, Geiger H, et al. Resistant hypertension? Assessment of adherence by toxicological urine analysis. J Hypertens. 2013;31:766–74.PubMedCrossRefGoogle Scholar
  10. 10.•
    Dragomir A, Cote R, Roy L, Blais L, Lalonde L, Berard A, et al. Impact of adherence to antihypertensive agents on clinical outcomes and hospitalization costs. Med Care. 2010;48:418–25. This study linked hypertensive medication adherence with vascular events, hospitalizations, and costs of healthcare.Google Scholar
  11. 11.
    Gwadry-Sridhar FH, Manias E, Lal L, Salas M, Hughes DA, Ratzki-Leewing A, et al. Impact of interventions on medication adherence and blood pressure control in patients with essential hypertension: a systematic review by the ISPOR medication adherence and persistence special interest group. Value Health. 2013;16:863–71.PubMedCrossRefGoogle Scholar
  12. 12.
    Bramlage P, Hasford J. Blood pressure reduction, persistence and costs in the evaluation of antihypertensive drug treatment—a review. Cardiovasc Diabetol. 2009;8:18.PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Lewis LM. Factors associated with medication adherence in hypertensive blacks: a review of the literature. J Cardiovasc Nurs. 2012;27:208–19.PubMedCrossRefGoogle Scholar
  14. 14.
    Lewis LM, Ogedegbe C, Ogedegbe G. Enhancing adherence of antihypertensive regimens in hypertensive African-Americans: current and future prospects. Expert Rev Cardiovasc Ther. 2012;10:1375–80.PubMedCrossRefGoogle Scholar
  15. 15.
    Matthes J, Albus C. Improving adherence with medication: a selective literature review based on the example of hypertension treatment. Deutsches Arzteblatt Int. 2014;111:41–7.Google Scholar
  16. 16.
    Takiya LN, Peterson AM, Finley RS. Meta-analysis of interventions for medication adherence to antihypertensives. Ann Pharmacother. 2004;38:1617–24.PubMedCrossRefGoogle Scholar
  17. 17.
    Glynn LG, Murphy AW, Smith SM, Schroeder K, Fahey T. Interventions used to improve control of blood pressure in patients with hypertension. Cochrane Database Syst Rev. 2010;3, CD005182. doi: 10.1002/14651858.CD005182.pub4.PubMedGoogle Scholar
  18. 18.
    Jayasinghe J. Non-adherence in the hypertensive patient: can nursing play a role in assessing and improving compliance? Can J Cardiovasc Nurs. 2009;19:7–12.PubMedGoogle Scholar
  19. 19.
    Morgado MP, Morgado SR, Mendes LC, Pereira LJ, Castelo-Branco M. Pharmacist interventions to enhance blood pressure control and adherence to antihypertensive therapy: review and meta-analysis. Am J Health Syst Pharm. 2011;68:241–53.PubMedCrossRefGoogle Scholar
  20. 20.
    Cooper H, Hedges LV, Valentine JC, editors. The handbook of research synthesis and meta-analysis. 2nd ed. New York: Russell Sage; 2009.Google Scholar
  21. 21.
    Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62:e1–34.PubMedCrossRefGoogle Scholar
  22. 22.
    World Health Organization. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003.Google Scholar
  23. 23.
    Vrijens B, De Geest S, Hughes DA, Przemyslaw K, Demonceau J, Ruppar T, et al. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol. 2012;73:691–705.PubMedCentralPubMedCrossRefGoogle Scholar
  24. 24.
    Borenstein M, Hedges L, Higgins JPT, Rothstein H. Introduction to meta-analysis. West Sussex: Wiley; 2009.CrossRefGoogle Scholar
  25. 25.
    Sutton AJ. Publication bias. In: Cooper H, Hedges L, Valentine J, editors. The handbook of research synthesis and meta-analysis. 2nd ed. New York: Russell Sage; 2009. p. 435–52.Google Scholar
  26. 26.
    Rothstein HR, Hopewell S. Grey literature. In: Cooper H, Hedges L, Valentine J, editors. The handbook of research synthesis and meta-analysis. 2nd ed. New York: Russell Sage; 2009. p. 103–25.Google Scholar
  27. 27.
    White H. Scientific communication and literature retrieval. In: Cooper H, Hedges L, Valentine J, editors. The handbook of research synthesis and meta-analysis. 2nd ed. New York: Russell Sage; 2009. p. 51–71.Google Scholar
  28. 28.
    Dickersin K, Scherer R, Lefebvre C. Identifying relevant studies for systematic reviews. BMJ. 1994;309:1286–91.PubMedCentralPubMedCrossRefGoogle Scholar
  29. 29.
    Stern JM, Simes RJ. Publication bias: evidence of delayed publication in a cohort study of clinical research projects. BMJ. 1997;315:640–5.PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.
    Easterbrook PJ. Directory of registries of clinical trials. Stat Med. 1992;11:363–423.PubMedCrossRefGoogle Scholar
  31. 31.
    Langham J, Thompson E, Rowen K. Identification of randomized controlled trials from the emergency medicine literature: comparison of hand searching versus MEDLINE searching. Ann Emerg Med. 1999;34:25–34.PubMedCrossRefGoogle Scholar
  32. 32.
    Wood JA. Methodology for dealing with duplicate study effects in a meta-analysis. Orgn Res Methods. 2008;11:79–95.CrossRefGoogle Scholar
  33. 33.
    Devine E. Issues and challenges in coding interventions for meta-analysis of prevention research. Meta-analysis of drug abuse prevention programs. Rockville: National Institute on Drug Abuse; 1997.Google Scholar
  34. 34.
    Orwin R, Vevea J. Evaluating coding decisions. In: Cooper H, Hedges L, Valentine J, editors. The handbook of research synthesis and meta-analysis. 2nd ed. New York: Russell Sage; 2009. p. 177–203.Google Scholar
  35. 35.
    Lipsey M, Wilson D. Practical meta-analysis. Thousand Oaks: Sage; 2001.Google Scholar
  36. 36.
    Raudenbush S. Random effects models. In: Cooper H, Hedges L, Valentine J, editors. The handbook of research synthesis and meta-analysis. 2nd ed. New York: Russell Sage; 2009. p. 295–315.Google Scholar
  37. 37.
    Hedges L, Vevea J. Fixed- and random-effects models in meta-analysis. Psychol Methods. 1998;3:486–504.CrossRefGoogle Scholar
  38. 38.
    Hedges L, Olkin I. Statistical methods for meta-analysis. Orlando: Academic; 1985.Google Scholar
  39. 39.
    Conn VS, Hafdahl AR, Mehr DR, LeMaster JW, Brown SA, Nielsen PJ. Metabolic effects of interventions to increase exercise in adults with type 2 diabetes. Diabetologia. 2007;50:913–21.PubMedCrossRefGoogle Scholar
  40. 40.
    Shadish W, Haddock C. Combining estimates of effect size. In: Cooper H, Hedges L, Valentine J, editors. The handbook of research synthesis and meta-analysis. 2nd ed. New York: Russell Sage; 2009. p. 257–77.Google Scholar
  41. 41.
    Nony P, Cucherat M, Haugh MC, Boissel JP. Critical reading of the meta-analysis of clinical trials. Therapie. 1995;50:339–51.PubMedGoogle Scholar
  42. 42.
    Helmer D, Savoie I, Green C, Kazanjian A. Evidence-based practice: extending the search to find material for the systematic review. Bull Med Libr Assoc. 2001;89:346–52.PubMedCentralPubMedGoogle Scholar
  43. 43.
    Conn VS, Rantz MJ. Research methods: managing primary study quality in meta-analyses. Res Nurs Health. 2003;26:322–33.PubMedCrossRefGoogle Scholar
  44. 44.
    de Vet HC, de Bie RA, van der Heijden GJ, Verhagen AP, Sijpkes P, Kipschild P. Systematic review on the basis of methodological criteria. Physiotherapy. 1997;1997:284–9.CrossRefGoogle Scholar
  45. 45.
    Valentine J. Judging the quality of primary research. In: Cooper H, Hedges L, Valentine J, editors. The handbook of research synthesis and meta-analysis. 2nd ed. New York: Russell Sage; 2009. p. 129–46.Google Scholar
  46. 46.
    Adeyemo A, Tayo BO, Luke A, Ogedegbe O, Durazo-Arvizu R, Cooper RS. The Nigerian antihypertensive adherence trial: a community-based randomized trial. J Hypertens. 2013;31:201–7.PubMedCentralPubMedCrossRefGoogle Scholar
  47. 47.
    Aguwa CN, Ukwe CV, Ekwunife OI. Effect of pharmaceutical care programme on blood pressure and quality of life in a Nigerian pharmacy. Pharm World Sci. 2008;30:107–10.PubMedCrossRefGoogle Scholar
  48. 48.
    Al Owaish RA. Compliance with, and effectiveness of, specialized care of hypertension in Kuwait [dissertation]. Chapel Hill, NC: University of North Carolina; 1985.Google Scholar
  49. 49.
    Alhalaiqa F, Deane KHO, Nawafleh AH, Clark A, Gray R. Adherence therapy for medication non-compliant patients with hypertension: a randomised controlled trial. J Hum Hypertens. 2012;26:117–26.PubMedCentralPubMedCrossRefGoogle Scholar
  50. 50.
    Amado Guirado E, Pujol Ribera E, Pacheco Huergo V, Borras JM. Knowledge and adherence to antihypertensive therapy in primary care: results of a randomized trial. Gac Sanit. 2011;25:62–7.PubMedCrossRefGoogle Scholar
  51. 51.
    Austin DL. Selected nursing interventions for noncompliant hypertensive patients [dissertation]. Denton, TX: Texas Women’s University; 1986.Google Scholar
  52. 52.
    Avanzini F, Corsetti A, Maglione T, Alli C, Colombo F, Torri V, et al. Simple, shared guidelines raise the quality of antihypertensive treatment in routine care. Am Heart J. 2002;144:726–32.PubMedCrossRefGoogle Scholar
  53. 53.
    Becker LA, Glanz K, Sobel E, Mossey J, Zinn SL, Knott KA. A randomized trial of special packaging of antihypertensive medications. J Fam Pract. 1986;22:357–61.PubMedGoogle Scholar
  54. 54.
    Beeson SA. The effect of teaching by the nurse on patient knowledge of medications and compliant behavior [master’s thesis]. Greensboro, NC: University of North Carolina; 1977.Google Scholar
  55. 55.
    Beune EJ, van Charante EP M, Beem L, Mohrs J, Agyemang CO, Ogedegbe G, et al. Culturally adapted hypertension education (CAHE) to improve blood pressure control and treatment adherence in patients of African origin with uncontrolled hypertension: cluster-randomized trial. PLoS One. 2014;9:e90103.PubMedCentralPubMedCrossRefGoogle Scholar
  56. 56.
    Blenkinsopp A, Phelan M, Bourne J, Dakhil N. Extended adherence support by community pharmacists for patients with hypertension: a randomised controlled trial. Int J Pharm Pract. 2000;8:165–75.CrossRefGoogle Scholar
  57. 57.
    Bogner H, de Vries H. Integration of depression and hypertension treatment: a pilot, randomized controlled trial. Ann Fam Med. 2008;6:295–301.PubMedCentralPubMedCrossRefGoogle Scholar
  58. 58.
    Boissel JP, Meillard O, Perrin-Fayolle E, Ducruet T, Alamercery Y, Sassano P, et al. Comparison between a bid and a tid regimen: improved compliance with no improved antihypertensive effect. Eur J Clin Pharmacol. 1996;50:63–7.PubMedCrossRefGoogle Scholar
  59. 59.
    Bosworth HB, Olsen MK, Neary A, Orr M, Grubber J, Svetkey L, et al. Take Control of Your Blood Pressure (TCYB) study: a multifactorial tailored behavioral and educational intervention for achieving blood pressure control. Patient Educ Couns. 2008;70:338–47.PubMedCentralPubMedCrossRefGoogle Scholar
  60. 60.
    Burrelle TN. Evaluation of an interdisciplinary compliance service for elderly hypertensives. J Geriatr Drug Ther. 1986;1:23–51.Google Scholar
  61. 61.
    Carter BL, Doucette WR, Franciscus CL, Ardery G, Kluesner KM, Chrischilles EA. Deterioration of blood pressure control after discontinuation of a physician-pharmacist collaborative intervention. Pharmacotherapy. 2010;30:228–35.PubMedCentralPubMedCrossRefGoogle Scholar
  62. 62.
    Cooper LA, Roter DL, Carson KA, Bone LR, Larson SM, Miller 3rd ER, et al. A randomized trial to improve patient-centered care and hypertension control in underserved primary care patients. J Gen Intern Med. 2011;26:1297–304.PubMedCentralPubMedCrossRefGoogle Scholar
  63. 63.
    Erickson SR, Ascione FJ, Kirking DM. Utility of electronic device for medication management in patients with hypertension: a pilot study. J Am Pharm Assoc (2003). 2005;45:88–91.CrossRefGoogle Scholar
  64. 64.
    Evans CE, Haynes RB, Birkett NJ, Gilbert JR, Taylor DW, Sackett DL, et al. Does a mailed continuing education program improve physician performance? Results of a randomized trial in antihypertensive care. JAMA. 1986;255:501–4.PubMedCrossRefGoogle Scholar
  65. 65.
    Fernandez S, Scales KL, Pineiro JM, Schoenthaler AM, Ogedegbe G. A senior center-based pilot trial of the effect of lifestyle intervention on blood pressure in minority elderly people with hypertension. J Am Geriatr Soc. 2008;56:1860–6.PubMedCrossRefGoogle Scholar
  66. 66.
    Fletcher SW, Appel FA, Bourgeois MA. Management of hypertension. Effect of improving patient compliance for follow-up care. J Am Med Assoc. 1975;233:242–4.CrossRefGoogle Scholar
  67. 67.
    Friedberg JP, Rodriguez MA, Watsula ME, Lin I, Wylie-Rosett J, Allegrante JP, et al. Effectiveness of a tailored behavioral intervention to improve hypertension control: primary outcomes of a randomized controlled trial. Hypertension. 2015;65:440–6.PubMedCrossRefGoogle Scholar
  68. 68.
    Gomez-Marcos M, Garcia-Ortiz L, Gonzalez-Elena LJ, Ramos-Delgado E, Gonzalez-Garcia AM, Parra-Sanchez J. Effectiveness of a quality improvement intervention in blood pressure control in primary care. Rev Clin Esp. 2006;206:428–34.PubMedCrossRefGoogle Scholar
  69. 69.
    Gonzalez-Fernandez RA, Rivera M, Torres D, Quiles J, Jackson A. Usefulness of a systemic hypertension in-hospital educational program. Am J Cardiol. 1990;65:1384–6.PubMedCrossRefGoogle Scholar
  70. 70.
    Hacihasanoğlu R, Gözüm S. The effect of patient education and home monitoring on medication compliance, hypertension management, healthy lifestyle behaviours and BMI in a primary health care setting. J Clin Nurs. 2011;20:692–705.PubMedCrossRefGoogle Scholar
  71. 71.
    Harowski KJ. The effect of problem solving training on compliance to a medical regimen for hypertension [dissertation]. Missoula, MT: University of Montana; 1983.Google Scholar
  72. 72.
    Harper DC. Application of Orem’s theoretical constructs to self-care medication behaviors in the elderly. Adv Nurs Sci. 1984;6:29–46.CrossRefGoogle Scholar
  73. 73.
    Hawkins DW, Fiedler FP, Douglas HL, Eschbach RC. Evaluation of a clinical pharmacist in caring for hypertensive and diabetic patients. Am J Hosp Pharm. 1979;36:1321–5.PubMedGoogle Scholar
  74. 74.
    Haynes RB, Sackett DL, Gibson ES, Taylor DW, Hackett BC, Roberts RS, et al. Improvement of medication compliance in uncontrolled hypertension. Lancet. 1976;1:1265–8.PubMedCrossRefGoogle Scholar
  75. 75.
    Hess PL, Reingold JS, Jones J, Fellman MA, Knowles P, Ravenell JE, et al. Barbershops as hypertension detection, referral, and follow-up centers for black men. Hypertension. 2007;49:1040–6.PubMedCrossRefGoogle Scholar
  76. 76.
    Hunt JS, Siemienczuk J, Pape G, Rozenfeld Y, MacKay J, LeBlanc BH, et al. A randomized controlled trial of team-based care: impact of physician-pharmacist collaboration on uncontrolled hypertension. J Gen Intern Med. 2008;23:1966–72.PubMedCentralPubMedCrossRefGoogle Scholar
  77. 77.
    Inui TS, Yourtee EL, Williamson JW. Improved outcomes in hypertension after physician tutorials. A controlled trial. Ann Intern Med. 1976;84:646–51.PubMedCrossRefGoogle Scholar
  78. 78.
    Jafar TH, Hatcher J, Poulter N, Islam M, Hashmi S, Qadri Z, et al. Community-based interventions to promote blood pressure control in a developing country: a cluster randomized trial. Ann Intern Med. 2009;151:593–601.PubMedCrossRefGoogle Scholar
  79. 79.
    Johnson AL, Taylor DW, Sackett DL, Dunnett CW, Shimizu AG. Self-recording of blood pressure in the management of hypertension. Can Med Assoc J. 1978;119:1034–9.PubMedCentralPubMedGoogle Scholar
  80. 80.
    Kauric-Klein Z. Improving blood pressure control in end stage renal disease through a supportive educative nursing intervention. Nephrol Nurs J. 2012;39:217–28.PubMedGoogle Scholar
  81. 81.
    Kim KB, Han HR, Huh B, Nguyen T, Lee H, Kim MT. The effect of a community-based self-help multimodal behavioral intervention in korean american seniors with high blood pressure. Am J Hypertens. 2014;27:1199–208.PubMedCentralPubMedCrossRefGoogle Scholar
  82. 82.
    Kim MT, Kim E, Han H, Jeong S, Lee JE, Park HJ, et al. Mail education is as effective as in-class education in hypertensive Korean patients. J Clin Hypertens. 2008;10:176–84.CrossRefGoogle Scholar
  83. 83.
    Kobalava Z, Villevalde S, Isikova KH, Pavlova E. Impact of integrated approach on blood pressure control in non adherent motivated. 20th European Meeting on Hypertension; Oslo, Norway. pp. e329. Accessed.Google Scholar
  84. 84.
    Leung LB, Busch AM, Nottage SL, Arellano N, Glieberman E, Busch NJ, et al. Approach to antihypertensive adherence: a feasibility study on the use of student health coaches for uninsured hypertensive adults. Behav Med. 2012;38:19–27.PubMedCentralPubMedCrossRefGoogle Scholar
  85. 85.
    Levine DM, Green LW, Deeds SG, Chwalow J, Russell RP, Finlay J. Health education for hypertensive patients. J Am Med Assoc. 1979;241:1700.CrossRefGoogle Scholar
  86. 86.
    Logan AG, Milne BJ, Achber C. A comparison of community and occupationally provided antihypertensive care. J Occup Environ Med. 1982;24:901–6.Google Scholar
  87. 87.
    Ma C, Zhou Y, Zhou W, Huang C. Evaluation of the effect of motivational interviewing counselling on hypertension care. Patient Educ Couns. 2014;95:231–7.PubMedCrossRefGoogle Scholar
  88. 88.
    Magadza C, Radloff SE, Srinivas SC. The effect of an educational intervention on patients’ knowledge about hypertension, beliefs about medicines, and adherence. Res Social Adm Pharm. 2009;5:363–75.PubMedCrossRefGoogle Scholar
  89. 89.
    Marquez Contreras E, Casado Martinez JJ, Celotti Gomez B, Gascon Vivo J, Martin de Pablos JL, Gil Rodriguez R, et al. Treatment compliance in arterial hypertension. A 2-year intervention trial through health education. Aten Primaria. 2000;26:5–10.PubMedCrossRefGoogle Scholar
  90. 90.
    Marquez Contreras E, de la Figuera von Wichmann M, Gil Guillen V, Ylla-Catala A, Figueras M, Balana M, et al. Effectiveness of an intervention to provide information to patients with hypertension as short text messages and reminders sent to their mobile phone (HTA-Alert). Aten Primaria. 2004;34:399–405.PubMedCrossRefGoogle Scholar
  91. 91.
    Marquez Contreras E, Martel Claros N, Gil Guillen V, Martin De Pablos JL, De la Figuera Von Wichman M, Casado Martinez JJ, et al. Non-pharmacological intervention as a strategy to improve antihypertensive treatment compliance. Aten Primaria. 2009;41:501–10.PubMedCrossRefGoogle Scholar
  92. 92.
    Marquez Contreras E, Vegazo Garca O, Claros NM, Gil Guillen V, de la Figuera von Wichmann M, Casado Martinez J, et al. Efficacy of telephone and mail intervention in patient compliance with antihypertensive drugs in hypertension. ETECUM-HTA study. Blood Press. 2005;14:151–8.PubMedCrossRefGoogle Scholar
  93. 93.
    Márquez-Contreras E, Martell-Claros N, Gil-Guillén V, Wichmann MF-V, Casado-Martínez JJ, Martin-de Pablos JL, et al. Efficacy of a home blood pressure monitoring programme on therapeutic compliance in hypertension: the EAPACUM-HTA study. J Hypertens. 2006;24:169–75.PubMedCrossRefGoogle Scholar
  94. 94.
    Martin MY, Kim YI, Kratt P, Litaker MS, Kohler CL, Schoenberger YM, et al. Medication adherence among rural, low-income hypertensive adults: a randomized trial of a multimedia community-based intervention. Am J Health Promot. 2011;25:372–8.PubMedCentralPubMedCrossRefGoogle Scholar
  95. 95.
    McGillicuddy JW, Gregoski MJ, Weiland AK, Rock RA, Brunner-Jackson BM, Patel SK, et al. Mobile health medication adherence and blood pressure control in renal transplant recipients: a proof-of-concept randomized controlled trial. JMIR Res Protoc. 2013;2, e32. doi: 10.2196/resprot.2633.PubMedCentralPubMedCrossRefGoogle Scholar
  96. 96.
    McKenney JM, Brown ED, Necsary R, Reavis HL. Effect of pharmacist drug monitoring and patient education on hypertensive patients. Contemp Pharm Pract. 1978;1:50–6.Google Scholar
  97. 97.
    McKenney JM, Slining JM, Henderson HR, Devins D, Barr M. The effect of clinical pharmacy services on patients with essential hypertension. Circulation. 1973;48:1104–11.PubMedCrossRefGoogle Scholar
  98. 98.
    McKinstry B, Hanley J, Wild S, Pagliari C, Paterson M, Lewis S, et al. Telemonitoring based service redesign for the management of uncontrolled hypertension: multicentre randomised controlled trial. BMJ. 2013;346:f3030. doi: 10.1136/bmj.f3030.PubMedCentralPubMedCrossRefGoogle Scholar
  99. 99.
    Mehos BM, Saseen JJ, MacLaughlin EJ. Effect of pharmacist intervention and initiation of home blood pressure monitoring in patients with uncontrolled hypertension. Pharmacotherapy. 2000;20:1384–9.PubMedCrossRefGoogle Scholar
  100. 100.
    Migneault J, Dedier J, Wright J, Heeren T, Campbell M, Morisky D, et al. A culturally adapted telecommunication system to improve physical activity, diet quality, and medication adherence among hypertensive African–Americans: a randomized controlled trial. Ann Behav Med. 2012;1–12.Google Scholar
  101. 101.
    Mitchell ML. Effects of a self-efficacy intervention on adherence to antihypertensive regimens [dissertation]. Rochester, NY: University of Rochester; 1993.Google Scholar
  102. 102.
    Moore JM, Shartle D, Faudskar L, Matlin OS, Brennan TA. Impact of a patient-centered pharmacy program and intervention in a high-risk group. J Manag Care Pharm. 2013;19:228–36.PubMedGoogle Scholar
  103. 103.
    Morgado M, Rolo S, Castelo-Branco M. Pharmacist intervention program to enhance hypertension control: a randomised controlled trial. Int J Clin Pharm. 2011;33:132–40.PubMedCentralPubMedCrossRefGoogle Scholar
  104. 104.
    Muhlhauser I, Sawicki P, Didjurgeit U, Jorgens V, Berger M. Uncontrolled hypertension in type 1 diabetes: assessment of patients’ desires about treatment and improvement of blood pressure control by a structured treatment and teaching programme. Diabet Med. 1988;5:693–8.PubMedCrossRefGoogle Scholar
  105. 105.
    Murray MD, Harris LE, Overhage JM, Zhou X, Eckert GJ, Smith FE, et al. Failure of computerized treatment suggestions to improve health outcomes of outpatients with uncomplicated hypertension: results of a randomized controlled trial. Pharmacotherapy. 2004;24:324–37.PubMedCrossRefGoogle Scholar
  106. 106.
    Ogedegbe G, Chaplin W, Schoenthaler A, Statman D, Berger D, Richardson T, et al. A practice-based trial of motivational interviewing and adherence in hypertensive African Americans. Am J Hypertens. 2008;21:1137–43.PubMedCentralPubMedCrossRefGoogle Scholar
  107. 107.
    Ogedegbe G, Tobin JN, Fernandez S, Cassells A, Diaz-Gloster M, Khalida C, et al. Counseling African Americans to control hypertension: cluster-randomized clinical trial main effects. Circulation. 2014;129:2044–51.PubMedCentralPubMedCrossRefGoogle Scholar
  108. 108.
    Oliver S, Jones J, Leonard D, Crabbe A, Delkhah Y, Nesbitt S. Improving adherence with amlodipine/atorvastatin therapy: IMPACT study. J Clin Hypertens. 2011;13:598–604. doi: 10.1111/j.1751-7176.2011.00478.x.CrossRefGoogle Scholar
  109. 109.
    Oparah AC, Adje DUO, Enato EF. Outcomes of pharmaceutical care intervention to hypertensive patients in a Nigerian community pharmacy. Int J Pharm Pract. 2006;14:115–22.CrossRefGoogle Scholar
  110. 110.
    Oser M. Evaluation of a bibliotherapy intervention for improving patients’ adherence to antihypertensive medications [dissertation]. Reno, NV: University of Nevada; 2008.Google Scholar
  111. 111.
    Park JJ, Kelly P, Carter BL, Burgess PP. Comprehensive pharmaceutical care in the chain setting. J Am Pharm Assoc. 1996;NS36:443–51.Google Scholar
  112. 112.
    Park YH, Chang H, Kim J, Kwak JS. Patient‐tailored self‐management intervention for older adults with hypertension in a nursing home. J Clin Nurs. 2013;22:710–22.PubMedGoogle Scholar
  113. 113.
    Patel S, Jacobus-Kantor L, Marshall L, Ritchie C, Kaplinski M, Khurana PS, et al. Mobilizing your medications: an automated medication reminder application for mobile phones and hypertension medication adherence in a high-risk urban population. J Diabetes Sci Technol. 2013;7:630–9.PubMedCentralPubMedCrossRefGoogle Scholar
  114. 114.
    Pertusa Martínez S, Quirce F, Saavedra MD, Merino J. Evaluation of 3 strategies to improve therapeutic compliance of patients with essential hypertension. Aten Primaria. 1998;22:670–1.PubMedGoogle Scholar
  115. 115.
    Pierce JP, Watson DS, Knights S, Gliddon T, Williams S, Watson R. A controlled trial of health education in the physician’s office. Prev Med. 1984;13:185–94.PubMedCrossRefGoogle Scholar
  116. 116.
    Pippalla RS. An impact assessment of pharmacist counseling on pharmaceutical care of hypertensives: interrelationships of compliance, quality of life, and therapeutic outcomes, with some policy perspectives [dissertation]. Morgantown, WV: University of West Virginia; 1994.Google Scholar
  117. 117.
    Pladevall M, Brotons C, Gabriel R, Arnau A, Suarez C, Marquez E, et al. Multicenter cluster-randomized trial of a multifactorial intervention to improve antihypertensive medication adherence and blood pressure control among patients at high cardiovascular risk (the COM99 study). Circulation. 2010;122:1183–91.PubMedCentralPubMedCrossRefGoogle Scholar
  118. 118.
    Planas L, Crosby KM, Mitchell KD, Farmer KC. Evaluation of a hypertension medication therapy management program in patients with diabetes. J Am Pharm Assoc (2003). 2009;49:164–70.CrossRefGoogle Scholar
  119. 119.
    Powell KW. Strategy to improve blood pressure control and medication adherence [dissertation]. Chicago, IL: Rush University; 2002.Google Scholar
  120. 120.
    Resnick B, Shaughnessy M, Galik E, Scheve A, Fitten R, Morrison T, et al. Pilot testing of the PRAISEDD intervention among African-American and low-income older adults. J Cardiovasc Nurs. 2009;24:352–61.PubMedCrossRefGoogle Scholar
  121. 121.
    Rinfret S, Lussier M, Peirce A, Duhamel F, Cossette S, Lalonde L, et al. The impact of a multidisciplinary information technology-supported program on blood pressure control in primary care. Circulation. 2009;2:170–7.PubMedGoogle Scholar
  122. 122.
    Robinson JD, Segal R, Lopez LM, Doty RE. Impact of a pharmaceutical care intervention on blood pressure control in a chain pharmacy practice. Ann Pharmacother. 2010;44:88–96.PubMedCrossRefGoogle Scholar
  123. 123.
    Roca-Cusachs A, Sort D, Altimira J, Bonet R, Guilera E, Monmany J, et al. The impact of a patient education programme in the control of hypertension. J Hum Hypertens. 1991;5:437–41.PubMedGoogle Scholar
  124. 124.
    Rodriguez MA. Is behavior change sustainable for diet, exercise, and medication adherence? [dissertation]. New York, NY: Yeshiva University; 2011.Google Scholar
  125. 125.
    Roumie CL, Elasy TA, Greevy R, Griffin MR, Liu X, Stone WJ, et al. Improving blood pressure control through provider education, provider alerts, and patient education: a cluster randomized trial. Ann Intern Med. 2006;145:165–75.PubMedCrossRefGoogle Scholar
  126. 126.
    Ruppar TM. Randomized pilot study of a behavioral feedback intervention to improve medication adherence in older adults with hypertension. J Cardiovasc Nurs. 2010;25:470–9.PubMedCrossRefGoogle Scholar
  127. 127.
    Saleem F, Hassali MA, Shafie AA, Ul Haq N, Farooqui M, Aljadhay H, et al. Pharmacist intervention in improving hypertensionrelated knowledge, treatment medication adherence and health-related quality of life: a non-clinical randomized controlled trial. Health Expect. 2013. doi: 10.1111/hex.12101.PubMedGoogle Scholar
  128. 128.
    Santschi V, Rodondi N, Bugnon O, Burnier M. Impact of electronic monitoring of drug adherence on blood pressure control in primary care: a cluster 12-month randomised controlled study. Eur J Intern Med. 2008;19:427–34.PubMedCrossRefGoogle Scholar
  129. 129.
    Saunders LD, Irwig LM, Gear JS, Ramushu DL. A randomized controlled trial of compliance improving strategies in Soweto hypertensives. Med Care. 1991;29:669–78.PubMedCrossRefGoogle Scholar
  130. 130.
    Schroeder K, Fahey T, Hollinghurst S, Peters TJ. Nurse-led adherence support in hypertension: a randomized controlled trial. Fam Pract. 2005;22:144–51.PubMedCrossRefGoogle Scholar
  131. 131.
    Sicras-Mainar A, Ibanez J, Firas X, Bulto C, Costa A, Majos N et al. Evaluation of Telemedicine Program (ITHACA): innovation in the treatment of arterial hypertension increasing the compliance and adherence. International Society for Pharmacoeconomics and Outcomes Research 17th Annual Meeting; Washington, D.C. pp. A528. Accessed.Google Scholar
  132. 132.
    Skaer TL, Sclar DA, Markowski DJ, Won JKH. Effect of value-added utilities in promoting prescription refill compliance among patients with hypertension. Curr Ther Res Clin Exp. 1993;53:251–5.CrossRefGoogle Scholar
  133. 133.
    Solomon DK, Portner TS, Bass GE, Gourley DR, Gourley GA, Holt JM, et al. Clinical and economic outcomes in the hypertension and COPD arms of a multicenter outcomes study. J Am Pharm Assoc. 1998;38:574–85.Google Scholar
  134. 134.
    Sookaneknun P, Richards RM, Sanguansermsri J, Teerasut C. Pharmacist involvement in primary care improves hypertensive patient clinical outcomes. Ann Pharmacother. 2004;38:2023–8.PubMedCrossRefGoogle Scholar
  135. 135.
    Stewart A, Noakes T, Eales C, Shepard K, Becker P, Veriawa Y. Adherence to cardiovascular risk factor modification in patients with hypertension. Cardiovasc J South Afr. 2005;16:102–7.Google Scholar
  136. 136.
    Stewart K, George J, Jackson SL, Peterson GM, Hughes JD, McNamara KP et al. Increasing community pharmacy involvement in the prevention of cardiovascular disease. 2008. 2012.
  137. 137.
    Svarstad BL, Kotchen JM, Shireman TI, Brown RL, Crawford SY, Mount JK, et al. Improving refill adherence and hypertension control in black patients: Wisconsin TEAM trial. J Am Pharm Assoc (2003). 2013;53:520–9.CrossRefGoogle Scholar
  138. 138.
    van de Steeg-van Gompel CHPA, Wensing M, De Smet PAGM. Implementation of adherence support for patients with hypertension despite antihypertensive therapy in general practice: a cluster randomized trial. Am J Hypertens. 2010;23:1038–45.CrossRefGoogle Scholar
  139. 139.
    Vivian EM. Improving blood pressure control in a pharmacist-managed hypertension clinic. Pharmacotherapy. 2002;22:1533–40.PubMedCrossRefGoogle Scholar
  140. 140.
    Walker CC. An educational intervention for hypertension management in older African Americans. Ethn Dis. 2000;10:165–74.PubMedGoogle Scholar
  141. 141.
    Wang J, Wu J, Yang J, Zhuang Y, Chen J, Qian W, et al. Effects of pharmaceutical care interventions on blood pressure and medication adherence of patients with primary hypertension in China. Clin Res Regul Aff. 2011;28:1–6.CrossRefGoogle Scholar
  142. 142.
    Wentzlaff DM, Carter BL, Ardery G, Franciscus CL, Doucette WR, Chrischilles EA, et al. Sustained blood pressure control following discontinuation of a pharmacist intervention. J Clin Hypertens. 2011;13:431–7.CrossRefGoogle Scholar
  143. 143.
    Werner RT, Sr. The effects of health education on the compliance of hypertensive patients to medical regimens [dissertation]. Philadelphia, PA: Temple University; 1979.Google Scholar
  144. 144.
    Wong MC, Liu KQ, Wang HH, Lee CL, Kwan MW, Lee KW, et al. Effectiveness of a pharmacist-led drug counseling on enhancing antihypertensive adherence and blood pressure control: a randomized controlled trial. J Clin Pharmacol. 2013;53:753–61. doi: 10.1002/jcph.101.PubMedCrossRefGoogle Scholar
  145. 145.
    Zang X, Liu J, Chai Y, Wong FKY, Zhao Y. Effect on blood pressure of a continued nursing intervention using chronotherapeutics for adult Chinese hypertensive patients. J Clin Nurs. 2010;19:1149–56.PubMedCrossRefGoogle Scholar
  146. 146.
    Zillich AJ, Sutherland JM, Kumbera PA, Carter BL. Hypertension outcomes through blood pressure monitoring and evaluation by pharmacists (HOME study). J Gen Intern Med. 2005;20:1091–6.PubMedCentralPubMedCrossRefGoogle Scholar
  147. 147.
    Mullen PD, Green LW, Persinger GS. Clinical trials of patient education for chronic conditions: a comparative meta-analysis of intervention types. Prev Med. 1985;14:753–81.PubMedCrossRefGoogle Scholar
  148. 148.
    Peterson AM, Takiya L, Finley R. Meta-analysis of trials of interventions to improve medication adherence. Am J Health Syst Pharm. 2003;60:657–65.PubMedGoogle Scholar
  149. 149.
    Conn VS, Hafdahl AR, Cooper PS, Ruppar TM, Mehr DR, Russell CL. Interventions to improve medication adherence among older adults: meta-analysis of adherence outcomes among randomized controlled trials. Gerontologist. 2009;49:447–62.PubMedCrossRefGoogle Scholar
  150. 150.
    Chase J, Bogener J, Ruppar T, Conn V. The effectiveness of medication adherence interventions among patients with coronary artery disease: a meta-analysis. J Cardiovasc Nurs. 2015. doi: 10.1097/JCN.0000000000000259.Google Scholar
  151. 151.
    Ruppar T. Improvement in heart failure mortality and readmission outcomes from medication adherence interventions: a meta-analysis. 2015.Google Scholar
  152. 152.
    Conn V, Ruppar T, Enriquez M, Cooper P. Medication adherence interventions that target subjects with adherence problems: systematic review and meta-analysis. Res Social Adm Pharm. In press.Google Scholar
  153. 153.
    Conn V, Enriquez M, Ruppar T, Chan K. Cultural relevance in medication adherence interventions with underrepresented adults: systematic review and meta-analysis of outcomes. Prev Med. 2014;69:239–47.PubMedCrossRefGoogle Scholar
  154. 154.
    Perreault S, Dragomir A, White M, Lalonde L, Blais L, Berard A. Better adherence to antihypertensive agents and risk reduction of chronic heart failure. J Intern Med. 2009;266:207–18.PubMedCrossRefGoogle Scholar
  155. 155.
    Lowy A, Munk VC, Ong SH, Burnier M, Vrijens B, Tousset EP, et al. Effects on blood pressure and cardiovascular risk of variations in patients’ adherence to prescribed antihypertensive drugs: role of duration of drug action. Int J Clin Pract. 2011;65:41–53.PubMedCrossRefGoogle Scholar
  156. 156.
    Mancia G, Messerli F, Bakris G, Zhou Q, Champion A, Pepine CJ. Blood pressure control and improved cardiovascular outcomes in the International Verapamil SR-Trandolapril Study. Hypertension. 2007;50:299–305.PubMedCrossRefGoogle Scholar
  157. 157.
    Mazzaglia G, Ambrosioni E, Alacqua M, Filippi A, Sessa E, Immordino V, et al. Adherence to antihypertensive medications and cardiovascular morbidity among newly diagnosed hypertensive patients. Circulation. 2009;120:1598–605.PubMedCrossRefGoogle Scholar
  158. 158.
    Roebuck MC, Liberman JN, Gemmill-Toyama M, Brennan TA. Medication adherence leads to lower health care use and costs despite increased drug spending. Health Aff (Millwood). 2011;30:91–9.CrossRefGoogle Scholar
  159. 159.
    Iuga AO, McGuire MJ. Adherence and health care costs. Risk Manag Healthc Policy. 2014;7:35–44.PubMedCentralPubMedGoogle Scholar
  160. 160.
    Shimizu M, Shibasaki S, Kario K. The value of home blood pressure monitoring. Curr Hypertens Rep. 2006;8:363–7.PubMedCrossRefGoogle Scholar
  161. 161.
    Alsabbagh MH, Lemstra M, Eurich D, Lix LM, Wilson TW, Watson E, et al. Socioeconomic status and nonadherence to antihypertensive drugs: a systematic review and meta-analysis. Value Health. 2014;17:288–96.PubMedCrossRefGoogle Scholar
  162. 162.
    Conn VS, Groves PS. Protecting the power of interventions through proper reporting. Nurs Outlook. 2011;59:318–25.PubMedCentralPubMedCrossRefGoogle Scholar
  163. 163.
    Michie S, Prestwich A. Are interventions theory-based? Development of a theory coding scheme. Health Psychol. 2010;29:1–8.PubMedCrossRefGoogle Scholar
  164. 164.
    Burnier M, Wuerzner G, Struijker-Boudier H, Urquhart J. Measuring, analyzing, and managing drug adherence in resistant hypertension. Hypertension. 2013;62:218–25.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Vicki S. Conn
    • 1
    Email author
  • Todd M. Ruppar
    • 2
  • Jo-Ana D. Chase
    • 3
  • Maithe Enriquez
    • 4
  • Pamela S. Cooper
    • 5
  1. 1.School of NursingUniversity of MissouriColumbiaUSA
  2. 2.School of NursingUniversity of MissouriColumbiaUSA
  3. 3.School of NursingUniversity of MissouriColumbiaUSA
  4. 4.School of NursingUniversity of MissouriColumbiaUSA
  5. 5.School of NursingUniversity of MissouriColumbiaUSA

Personalised recommendations