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Compliance and hypertension

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Abstract

Despite decades of attention to noncompliance to treatment for hypertension, the problem remains a significant factor in the inadequate control of blood pressure. Current approaches to enhancing compliance use patient demographics, medication characteristics, clinical factors, health beliefs, and the quality of patient-provider communication. Clinical researchers are just beginning to apply a new approach that views compliance as a behavior change taking place over time. In this view, patients do not simply change their behavior through a one-time decision to take their medication as directed by their physicians; they move through five stages of behavior change. Clinicians can increase compliance by assessing their patients to determine the patient’s stage of behavior change, then matching their interventions to that stage.

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References and Recommended Reading

  1. Hill MN, Miller NH: Compliance enhancement, a call for multidisciplinary team approaches. Circulation 1996, 93:4–6.

    PubMed  CAS  Google Scholar 

  2. Rudd P, Ahmed S, Zachary V, et al.: Antihypertensive drug trials, contributions from medication monitors. In In Patient compliance in medical practice and clinical trials. Edited by Cramer JA, Spilker B. New York: Raven Press, Ltd., 1991:283–299.

    Google Scholar 

  3. Urquhart J: When outpatient drug treatment fails: identifying noncompliers as a cost containment tool. Medical Interface 1993, 6:65–73.

    Google Scholar 

  4. Bittar N: Maintaining long-term control of blood pressure: the role of improved compliance. Clin Cardiol 1995, 18:III12-III16.

    Article  CAS  Google Scholar 

  5. Juncos LI: Patient compliance and angiotensin-converting enzyme inhibitors in hypertension. J Cardiovasc Pharmacol 1990, 15(suppl 3):22–25.

    Article  Google Scholar 

  6. Caro JJ, Speckman JL: Existing treatment strategies: doe noncompliance make a difference. J Hypertens 1998, 16(suppl 7):31–34. This paper reviews the literature on therapeutic choices and compliance. It also reports the effects of different initial drug choices on compliance over time, using data from the provincial health plan of Saskatchewan, Canada.

    Google Scholar 

  7. American Heart Association: 1998 Heart and Stroke Statistical Update. Dallas: American Heart Association, 1997.

    Google Scholar 

  8. National High Blood Pressure Program Coordinating Committee: The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC VI). Arch Intern Med 1997, 157:2413–2446.

    Article  Google Scholar 

  9. Eichert JH, Wong H, Smith DR: The disease management development process. In In Disease Management: A systems Approach to Improving Patient Outcomes. Edited by Todd WE, Nash D. Chicago: American Hospital Publishing Inc., 1997:27–60.

    Google Scholar 

  10. Sullivan SD, Kreling DH, Hazlet TK: Noncompliance with medication regimens and subsequent hospitalizations: a literature analysis and cost of hospitalization estimate. J Research in Pharmaceutical Economics 1990, 2:19–33.

    Google Scholar 

  11. Stason WB: Opportunities to improve the cost-effectiveness of treatment for hypertension. Hypertension 1991, 18:161–166.

    Google Scholar 

  12. Skaer TL, Sclar, DA, Robinson LM, et al.: Effect of pharmaceutical formulation for antihypertensive therapy on health service utilization. Clin Ther 1993, 15:715–725.

    PubMed  CAS  Google Scholar 

  13. Dahlström B, Eckernäs S: Patient computers to enhance compliance with completing questionnaires: a challenge for th 1990s. In In Patient Compliance in Medical Practice and Clinical Trials. Edited by Cramer JA, Spilker B. New York, NY: Raven Press, Ltd; 1991:233–242.

    Google Scholar 

  14. Julius S: Current trends in the treatment of hypertension: a mixed picture. Am J Hypertens 1997, 10:300S-305S.

    Article  PubMed  CAS  Google Scholar 

  15. Franklin SS, Khan SA, Wong ND, et al.: Is pulse pressure more important than systolic blood pressure in predicting coronary heart disease events? The Framingham Heart Study [abstract]. Circulation 1998, 98(suppl I):324.

    Google Scholar 

  16. Rizzo JA, Simons WR: Variations in compliance among hypertensive patients by drug class: implications for health care costs. Clin Ther 1997, 19:1446–1457.

    Article  PubMed  CAS  Google Scholar 

  17. Sanson-Fisher RW, Clover K: Compliance in the treatment of hypertension, a need for action. Am J Hypertens 1995, 8:82S-88S.

    Article  PubMed  CAS  Google Scholar 

  18. Gallup G Jr, Cotugno HE: Preferences and practices of Americans and their physicians in antihypertensive therapy. Am J Med 1986, 81(suppl 6c):20–24.

    Article  PubMed  Google Scholar 

  19. Rosenstock IM: The health belief model: explaining health behavior through expectancies. Health Educ Behav 1989, 16:v39-v62.

    Google Scholar 

  20. Richardson MA, Simons-Morton B, Annegers JF: Effect of perceived barriers on compliance with anti-hypertensive medication. Health Educ Q 1993, 20:489–503.

    PubMed  CAS  Google Scholar 

  21. Montaño DE, Kasprzyk D, Taplin SH: The theory of reasoned action and the theory of planned behavior. In In Health Behavior and Health Education, Theory, Research, and Practice. Edited by Glanz K, Lewis FM, Rimer BK. San Francisco: Jossey-Bass; 1997:85–112.

    Google Scholar 

  22. Curry SJ, Emmons KM: Theoretical models for predicting and improving compliance with breast cancer screening. Ann Behav Med 1994, 16:303–316.

    Google Scholar 

  23. Ménard J, Chatellier G: Limiting factors in the control of BP: why is there a gap between theory and practice? J Hum Hypertens 1995, 9:519–523.

    Google Scholar 

  24. Miller NH, Hill M, Kottke T, et al.: The multilevel compliance challenge: recommendations for a call to action: statement for healthcare professionals. Circulation 1997, 95:1085–1090. An expert panel on compliance sponsored by the American Heart Association recommends both belief and behavioral interventions to enhance compliance. The panel examines compliance interventions from the standpoint of the patient, provider, and healthcare organization.

    PubMed  CAS  Google Scholar 

  25. Taylor SE: Health psychology: the science and the field. Am Psychol 1990, 45:40–50.

    Article  PubMed  CAS  Google Scholar 

  26. Levine DM, Bone L: The impact of a planned health education approach on the control of hypertension in a high risk population. J Hum Hypertens 1990, 4:317–321.

    PubMed  CAS  Google Scholar 

  27. Sawicki PT, Mühlhauser I, Didjurgert V, et al.: Improvement of hypertension care by a structured treatment and teaching program. J Hum Hyperten 1993, 7:571–573.

    CAS  Google Scholar 

  28. Becker MH, Maiman LA: Strategies for enhancing patient compliance. J Community Health 1980, 6:113–135.

    Article  PubMed  CAS  Google Scholar 

  29. Nagy VT, Wolfe GR: Cognitive predictors of compliance in chronic disease patients. Med Care 1984, 22:912–921.

    Article  PubMed  CAS  Google Scholar 

  30. Ménard J, Chatellier G: Limiting factors in the control of BP: why is there a gap between theory and practice? J Hum Hypertens 1995, 9:519–523.

    Google Scholar 

  31. Haynes RB, Taylor DW, Sackett DL, et al.: Can simple clinical measurements detect patient noncompliance? Hypertension 1980, 2:757–764.

    PubMed  CAS  Google Scholar 

  32. Prochaska JO, Clemente CC, Norcross JC: In search of how people change: applications to addictive behaviors. Am Psychol 1992, 47:1102–1114. This paper provides a good introduction to the stages of change theory.

    Article  PubMed  CAS  Google Scholar 

  33. Willey C, Redding C, Rossi S, et al.: A comparison of two methods of measuring stage of change for adherence with medication. Ann Behav Med 1998, 20(supp):S027. This paper applies stages of change theory to compliance. It also addresses methodologic issues, especially those related to measurement of compliance.

    Google Scholar 

  34. Willey C, Stafford J, Geletko S, et al.: Stages of change for adherence with medication. Ann Behav Med 1999, 21:S156. This paper describes research applying stages of change theory to compliance for treatment of hypertension and HIV.

    Google Scholar 

  35. Prochaska JO, Velicer WF, Rossi JS, et al.: Stages of change and decisional balance for 12 problem behaviors. Health Psychol 1994, 13:39–46.

    Article  PubMed  CAS  Google Scholar 

  36. Prochaska JO: Strong and weak principles for progressing from precontemplation to action on the basis of twelve problem behaviors. Health Psychol 1994, 13:47–51.

    Article  PubMed  CAS  Google Scholar 

  37. Sclar DA, Skaer TL: Pharmaceutical formulation and healthcare expenditures. Pharmacoeconomics 1992, 2:267–269.

    Article  PubMed  CAS  Google Scholar 

  38. Lewis BF, Garfield F, Orsini KC, et al.: In Walking the walk, talking the talk: implementation and process analysis issues in four residential treatment models. In Drug Abuse Treatment: the Implementation of Innovative Approaches. Edited by Fletcher BW, Inciardi JA, Horton AM. Westport, CT:Greenwood Publishing Group, Inc.; 1994:45–62.

    Google Scholar 

  39. Winett RA: A framework for health promotion and disease prevention programs. Am Psychol 1995, 50:341–350.

    Article  PubMed  CAS  Google Scholar 

  40. Marcus BH, Eaton CA, Rossi JS, et al.: Self-efficacy, decision making, and stages of change: an integrative model of physical exercise. J Appl Soc Psychol 1994, 24:489–508.

    Article  Google Scholar 

  41. Longabaugh R, Wirtz PW, DiClemente CC, et al.: Issues in the development of client-treatment matching hypotheses. J Stud Alcohol 1994, 12:46–59.

    CAS  Google Scholar 

  42. Rossi JS: Why do people fail to maintain weight loss? In Obesity Treatment. Edited by Allison DB, Pi-Sunyer FX. New York, NY: Obesity Treatment Plenum Press; 1995:97–102.

    Google Scholar 

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Garfield, F.B., Caro, J.J. Compliance and hypertension. Curr Hypertens Rep 1, 502–506 (1999). https://doi.org/10.1007/s11906-996-0022-y

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  • DOI: https://doi.org/10.1007/s11906-996-0022-y

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