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Adherence to Antihypertensive Therapy and Its Determinants: A Systematic Review

2024-05-02Journal article Open access
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dc.contributor.authorFerreira, Pedro Duarte De Sousa
dc.contributor.authorSimões, José Augusto Rodrigues
dc.contributor.authorVelho, Denise Alexandra Cunha
dc.date.accessioned2024-05-03T08:43:26Z
dc.date.available2024-05-03T08:43:26Z
dc.date.issued2024-05-02
dc.description.abstractHypertension is a globally prevalent condition, and low adherence to antihypertensive therapy is considered one of the main causes of poor blood pressure (BP) control. Non-adherence to antihypertensive treatment is a complex issue that can arise from various factors; however, gaining an understanding of this provides key targets for intervention strategies. This study aimed to provide an overview of the current status and recent developments regarding our understanding of the determinants of patients' adherence to antihypertensives. A systematic review was performed using the electronic databases MEDLINE/PubMed, Web of Science, Scientific Electronic Library Online (SciELO), and “Índex das Revistas Médicas Portuguesas”, which included studies published between 2017 and 2021 following the PICOS model: (P) Adult patients with the diagnosis of primary hypertension, using at least one antihypertensive agent; (I) all interventions on both pharmacological and non-pharmacological level; (C) patient’s adherence against their non-adherence; (O) changes in adherence to the therapeutic plan; and (S) any study design (except review articles) written in English, French, Spanish or Portuguese. Articles were reviewed by two researchers and their quality was assessed. Subsequently, determinants were classified according to their consistent or inconsistent association with adherence or non-adherence. Only 45 of the 635 reports identified met the inclusion criteria. Adherence was consistently associated with patient satisfaction with communication, patient-provider relationship, their treatment, and use of eHealth and mHealth strategies; a patient’s mental and physical health, including depression, cognitive impairment, frailty, and disability, previous hospitalization, occurrence of vital events; drug treatment type and appearance; and unwillingness due to health literacy, self-efficacy, and both implicit and explicit attitudes towards treatment. There were discrepancies regarding the association of other factors to adherence, but these inconsistent factors should also be taken into account. In conclusion, the barriers to adherence are varied and often interconnected between socioeconomic, patient, therapy, condition, and healthcare system levels. Healthcare teams should invest in studying patients’ non-adherence motives and tailoring interventions to individual levels, by using a multifaceted approach to assess adherence. Further research is needed to analyze the impact of implicit attitudes, the use of new technological approaches, and the influence of factors that are inconsistently associated with non-adherence, to understand their potential in implementing adherence strategies.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.7759/cureus.59532pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.6/14388
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.relation.ispartofseries5;e59532
dc.relation.publisherversionhttps://www.cureus.com/articles/249253-adherence-to-antihypertensive-therapy-and-its-determinants-a-systematic-review#!/pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectTelemedical technologypt_PT
dc.subjectMobile apps (mhealth)pt_PT
dc.subjectPreventive healthpt_PT
dc.subjectAntihypertensive agentspt_PT
dc.subjectPrimary health carept_PT
dc.subjectMedication adherence strategiespt_PT
dc.subjectAntihypertensive therapypt_PT
dc.subjectHypertensionpt_PT
dc.titleAdherence to Antihypertensive Therapy and Its Determinants: A Systematic Reviewpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleCureuspt_PT
oaire.citation.volume16pt_PT
person.familyNamede Sousa Ferreira
person.familyNameRodrigues Simões
person.familyNameVelho
person.givenNamePedro Duarte
person.givenNameJosé Augusto
person.givenNameDenise
person.identifierL-4695-2016
person.identifier.ciencia-idE419-CED2-38BA
person.identifier.ciencia-id531E-DBEE-6132
person.identifier.orcid0000-0002-2214-8407
person.identifier.orcid0000-0003-2264-7086
person.identifier.orcid0000-0003-1341-1047
person.identifier.scopus-author-id36896116500
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication898f5c84-f5a6-4521-b424-35f1e7f7605a
relation.isAuthorOfPublication919b504d-aaa9-40ee-a1a5-40e1e0a57f6f
relation.isAuthorOfPublicationf1b77f15-0632-482d-abaf-5ae1a7d181d1
relation.isAuthorOfPublication.latestForDiscoveryf1b77f15-0632-482d-abaf-5ae1a7d181d1

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