Intervention strategies to improve adherence among hypertensives: review and recommendations.

Hypertension is a leading public health problem, which significantly increases the risks of death and disability from cardiovascular and cerebrovascular diseases. Medical treatment is effective for reducing hypertension and the associated risks, but nonadherence to recommendations for treatment has limited the realization of benefits of advances in medical care. This paper reviews recent attempts to improve adherence to medical regimens for the control of high blood pressure. Adherence to antihypertension regimens is defined as a behavioral problem, which includes a series of steps: participation in screening, entering treatment, continuing treatment, and adhering to the prescribed regimen. In the past decade, a wide range of structural and educational interventions attempting to increase adherence have had varying degrees of success. The interventions, their efficacy, study designs, and populations studied are reviewed, and recommendations for future testing and adoption of strategies for improving management of hypertension are advance.