Adherence to Antihypertensive Medications: A Review and Update

Authors: >Francesco Vittorio Costa,¹; D'Ausilio, Anna²; Bianchi, Cosetta³; Negrini, Cristina²; Lopatriello, Stefania⁴

Source: High Blood Pressure & Cardiovascular Prevention, Volume 16, Number 3, 1 September 2009 , pp. 101-110(10)

Publisher: Adis International

Abstract:

The aim of this review was to summarize recent findings on patients' adherence and persistence to antihypertensive (AHT) therapy. A literature search was performed using MEDLINE for original studies published in the English language between April 2003 and July 2008. According to selection criteria, the review included 47 papers classified into the following groups: (i) studies assessing overall behaviour towards treatment; (ii) studies differentiating among AHT classes; and (iii) studies comparing specific AHTs. It was not possible to perform a meta-analysis due to the wide variety of study designs, objectives and definitions. However, some strong messages emerged: non-adherent patients have higher blood pressure (BP) values, which lead to a higher risk of cardiovascular events; angiotensin II type 1 receptor antagonists (angiotensin receptor blockers) are the AHTs with the best patient adherence and persistence to treatment; better treatment adherence is observed in patients using fixed versus extemporaneous AHT combinations. Improving BP control is pivotal to reduce cardiovascular events, allowing for a better use of healthcare resources, and good adherence and persistence to treatment are essential for reaching this goal.

Received for publication 18 May 2009; accepted for publication 3 July 2009.

Keywords: antihypertensive drugs, compliance to treatment, adherence to treatment, treatment discontinuation, cost of non-compliance.

Document Type: Research article

Affiliations: 1: 1 Former Associate Professor of Internal Medicine, University of Bologna, Bologna, Italy 2: 2 PBE Consulting, Milan, Italy 3: 3 Health Economics, Outcome, Pricing and Reimbursement-Bayer Schering Pharma, Milan, Italy 4: 4 PBE Consulting, Verona, Italy

Publication date: 2009-09-01

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