[How to assess and to improve adherence in clinical practice?]

Prevalence of non-adherence of pharmacological therapy in hypertension is between 35 and 50%. In every uncontrolled hypertensive one should assess drug adherence as the cause. Several validated methods to detect noncompliance exist, being most frequently used Haynes test, pill count, and use of electronic prescription. Strategies to improve compliance should include a combination of adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. Programs for home self-measurement of blood pressure, use of double or triple drug fixed combinations, group health education, reminders, calendars, and cards enforcement, and improving doctor-patient relationship are also useful tools for compliance optimization.