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Overcoming barriers: the role of providers in improving patient adherence to antihypertensive medications

Harmon, Garya; Lefante, Johnb; Krousel-Wood, Mariea,c

Current Opinion in Cardiology: July 2006 - Volume 21 - Issue 4 - p 310–315
doi: 10.1097/01.hco.0000231400.10104.e2

Purpose of review To provide an overview of recent research assessing the role of physicians and other healthcare providers in facilitating improvements in patient adherence to antihypertensive medications, to provide a framework for addressing patient adherence to antihypertensive therapy, and to propose future directions for assessing the risk of poor adherence in clinical settings.

Recent findings Several recent studies have highlighted the role of the healthcare provider in improving patient adherence to antihypertensive therapy. Opportunities exist for providers to improve communication that enhances patients' understanding of their disease and its treatment, to tailor interventions based on whether patients are intentionally or unintentionally non-adherent, to assess and treat side-effects such as erectile dysfunction, to switch to less costly generic alternatives, and to reduce the complexities of medication regimens.

Summary Poor adherence to prescribed therapies is common in patients with hypertension, and should be considered in the evaluation of the hypertensive patient with poor blood pressure control. When initiating treatment in patients newly diagnosed with hypertension and when monitoring patients with existent disease, providers should identify barriers to medication adherence and actively engage patients in shared decision-making regarding their treatment. These activities will facilitate adherence, which may lead to improved outcomes for patients with hypertension and other chronic cardiovascular diseases.

aDepartments of Epidemiology, USA

bBiostatistics, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisana, USA

cOchsner Clinic Foundation, Center for Health Research, New Orleans, Louisana, USA

Correspondence to Marie Krousel-Wood MD, MSPH, Ochsner Clinic Foundation, Center for Health Research, 1514 Jefferson Highway, New Orleans, LA 70121, USA Tel: +1 504 842 3680; fax: +1 504 842 3648; e-mail:

© 2006 Lippincott Williams & Wilkins, Inc.