Effective strategies to improve adherence to hypertension treatment in primary health care patients

Authors

  • Sthefanie da Silva Bessa Santa Casa de Misericórdia de Votuporanga Author https://orcid.org/0000-0001-7562-1643
  • Miguel Lucas Silva Valente Universidade Federal do Acre (UFAC) Author https://orcid.org/0009-0009-9434-6136
  • Jallys Rafael Gonçalves Pessoa Santa Casa de Misericórdia de Votuporanga Author
  • Betina Cavini Peñuela Ortega Santa Casa de Misericórdia de Votuporanga Author
  • Acácio Mitsuo Homa Júnior Centro Universitário de Votuporanga (UNIFEV) Author
  • Beatriz Balabanian Centro Universitário de Votuporanga (UNIFEV) Author
  • Beatriz Ferreira Garcia Centro Universitário de Votuporanga (UNIFEV) Author

DOI:

https://doi.org/10.5281/zenodo.15276511

Keywords:

Hypertension, Primary Health Care, Treatment Adherence, Health Interventions, Systematic Review

Abstract

Introduction: Hypertension is a leading contributor to global cardiovascular morbidity and mortality. Despite effective treatments, poor adherence remains a critical barrier, particularly in primary health care (PHC). Objective: To identify and critically evaluate effective interventions to improve adherence to hypertension treatment among adults in PHC settings. Methods: Systematic review of intervention studies following PRISMA 2020 guidelines. Results: Seventeen studies indicated that multicomponent approaches—combining education, multidisciplinary support, and m‑health technologies—enhance medication adherence, disease knowledge, and, in some cases, significantly reduce blood pressure. Conclusion: Context‑adapted, multicomponent strategies are more effective at improving therapeutic adherence in PHC.

References

AGARWAL, G. et al. Designing a comprehensive Non-Communicable Diseases (NCD) programme for hypertension and diabetes at primary health care level: evidence and experience from urban Karnataka, South India. BMC Public Health, v. 19, p. 409, 2019.

ALFIAN, S. D. et al. Targeted and tailored pharmacist-led intervention to improve adherence to antihypertensive drugs among patients with type 2 diabetes in Indonesia: study protocol of a cluster randomised controlled trial. BMJ Open, v. 10, p. e034507, 2020.

DAUGHERTY, S. L. et al. Effect of Values Affirmation on Reducing Racial Differences in Adherence to Hypertension Medication: The HYVALUE Randomized Clinical Trial. JAMA Network Open, v. 4, n. 12, p. e2139533, 2021.

GUPTA, S. et al. Effect of low-salt food preparation demonstration compared to routine health education on salt intake and blood pressure among patients with hypertension. Nigerian Postgraduate Medical Journal, v. 32, p. 39–46, 2025.

IRIZARRY, T. et al. Development and Preliminary Feasibility of an Automated Hypertension Self-Management System. American Journal of Medicine, v. 131, n. 9, p. 1125.e1–1125.e8, 2018.

JAYANNA, K. et al. Designing a comprehensive Non-Communicable Diseases (NCD) programme for hypertension and diabetes at primary health care level. BMC Public Health, v. 19, p. 409, 2019.

KASSAVOU, A.; SUTTON, S. Reasons for non-adherence to cardiometabolic medications, and acceptability of an interactive voice response intervention in patients with hypertension and type 2 diabetes. BMJ Open, v. 7, p. e015597, 2017.

KASSAVOU, A. et al. Development and piloting of a highly tailored digital intervention to support adherence to antihypertensive medications. BMJ Open, v. 9, p. e024121, 2019.

KRAVETZ, J. D.; WALSH, R. F. Team-Based Hypertension Management to Improve Blood Pressure Control. Journal of Primary Care & Community Health, v. 7, p. 272–275, 2016.

MARTÍNEZ-MARDONES, F. et al. Systematic Review and Meta-Analysis of Medication Reviews Conducted by Pharmacists on Cardiovascular Diseases Risk Factors. Journal of the American Heart Association, v. 8, n. 22, p. e013627, 2019.

MEHTA, S. J. et al. Remote Blood Pressure Monitoring With Social Support for Patients With Hypertension. JAMA Network Open, v. 7, n. 6, p. e2413515, 2024.

MOHAMAD, M. et al. Self-reported medication adherence among patients with diabetes or hypertension. PLoS One, v. 16, n. 5, p. e0251316, 2021.

MORRISSEY, E. C. et al. Supporting GPs and people with hypertension to maximise medication use: a pilot cluster RCT. BMC Primary Care, v. 25, p. 394, 2024.

OLAIYA, M. T. et al. Community-Based Intervention to Improve Cardiometabolic Targets in Patients With Stroke. Stroke, v. 48, p. 2504–2510, 2017.

PARRA, D. I. et al. Teaching: individual to improve adherence in hypertension and type 2 diabetes. British Journal of Community Nursing, v. 26, p. 84–91, 2021.

SANTSCHI, V. et al. Team-based care for improving hypertension management among outpatients. BMC Cardiovascular Disorders, v. 17, p. 39, 2017.

SEITSHIRO, S. E. et al. Effect of adult day care centre attendance on hypertension management. South African Family Practice, v. 66, p. e1–e4, 2024.

SHIREMAN, T. I.; SVARSTAD, B. L. Cost-effectiveness of Wisconsin TEAM model for improving adherence and hypertension control in black patients. Journal of the American Pharmacists Association, v. 56, p. 389–396, 2016.

VEDANTHAN, R. et al. Community Health Workers Improve Linkage to Hypertension Care in Western Kenya. Journal of the American College of Cardiology, v. 74, n. 15, p. 1897–1906, 2019.

Published

2025-04-24

Issue

Section

Articles

How to Cite

BESSA , Sthefanie da Silva; VALENTE, Miguel Lucas Silva; PESSOA, Jallys Rafael Gonçalves; ORTEGA, Betina Cavini Peñuela; HOMA JÚNIOR, Acácio Mitsuo; BALABANIAN, Beatriz; FERREIRA GARCIA, Beatriz. Effective strategies to improve adherence to hypertension treatment in primary health care patients. Journal of Social Issues and Health Sciences (JSIHS), [S. l.], v. 2, n. 4, 2025. DOI: 10.5281/zenodo.15276511. Disponível em: https://ojs.thesiseditora.com.br/index.php/jsihs/article/view/392.. Acesso em: 4 feb. 2026.