Doctor-Patient Communication to Improve Adherence to Anti- Hypertensive Treatment

Background Nonadherence to antihypertensive medications is the leading cause of poor blood pressure control and thereby cardiovascular diseases and mortality worldwide. Methods and Results We investigated the global epidemiology, regional differences, and trend of antihypertensive medication nonadherence via a systematic review and meta‐analyses of data from 2010 to 2020. Multiple medical databases and clinicaltrials.gov were searched for articles. Observational studies reporting the proportion of patients with anti‐hypertensive medication nonadherence were included. The proportion of nonadherence, publication year, year of first recruitment, country, and health outcomes attributable to antihypertensive medication nonadherence were extracted. Two reviewers screened abstracts and full texts, classified countries according to levels of income and locations, and extracted data. The Joanna Briggs Institute prevalence critical appraisal tool was used to rate the included studies. Prevalence meta‐analyses were conducted using a fixed‐effects model, and trends in prevalence were analyzed using meta‐regression. The certainty of evidence concerning the effect of health consequences of nonadherence was rated according to Grading of Recommendations, Assessment, Development and Evaluations. A total of 161 studies were included. Subject to different detection methods, the global prevalence of anti‐hypertensive medication nonadherence was 27% to 40%. Nonadherence was more prevalent in low‐ to middle‐income countries than in high‐income countries, and in non‐Western countries than in Western countries. No significant trend in prevalence was detected between 2010 and 2020. Patients with antihypertensive medication nonadherence had suboptimal blood pressure control, complications from hypertension, all‐cause hospitalization, and all‐cause mortality. Conclusions While high prevalence of anti‐hypertensive medication nonadherence was detected worldwide, higher prevalence was detected in low‐ to middle‐income and non‐Western countries. Interventions are urgently required, especially in these regions. Current evidence is limited by high heterogeneity. Registration URL: www.crd.york.ac.uk/prospero/ ; Unique identifier: CRD42021259860.

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The impact of doctor–patient communication on medication adherence and blood pressure control in patients with hypertension: a systematic review

Zeng,

Gao,

Hou

et al. 2024

PeerJ

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Background This systematic review aims to present existing evidence concerning the effects of doctor–patient communication on medication adherence and blood pressure control in hypertensive patients. Methods Two researchers independently conducted comprehensive searches of five databases and screened relevant studies published from the inception of these databases up to July 21, 2024. The titles, abstracts, and full texts of all the retrieved articles subsequently underwent rigorous duplicate screening, according to predefined inclusion and exclusion criteria. We then synthesized the findings in a narrative format of the included studies. Finally, two researchers independently assessed study quality. Results Eighteen observational studies encompassing 21,542 patients and seven randomized controlled trials with 2,804 patients were included in the systematic review. Diverse approaches were employed for evaluating doctor–patient communication and medication adherence in these studies, with identified themes including communication content and communication skills. Various facets of doctor–patient communication, including patient satisfaction with doctor–patient communication, the specific content discussed, the style of communication, the comprehensive communication skills of doctors, and the duration of these conversations, were scrutinized. In general, the results suggest a promising link between effective doctor–patient communication and increased medication adherence and blood pressure control. Nonetheless, the presence of nuanced variations and subtle distinctions within the literature underscores the imperative for deeper exploration and consideration in clinical practice. Additionally, effective communication interventions must attain a certain threshold of intensity and endure for an adequate duration. Conclusion This review underscores the pivotal role of robust doctor–patient communication in improving both medication adherence and blood pressure control. Nevertheless, additional research may be warranted to address the disparities and subtleties in the literature and to establish precise implications for clinical practice. Moreover, in clinical practice, strategies to enhance doctor–patient communication should be incorporated, given the potential to improve medication adherence and blood pressure control among hypertensive patients. Trial registration Systematic review registration: PROSPERO with registration number CRD42024503112.

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Doctor-Patient Communication to Improve Adherence to Anti- Hypertensive Treatment

Cited by 3 publications

References 12 publications

The Associations Between Physician-Patient Communication and Adjustment Outcomes of Patients and Physicians: A Systematic Review and Meta-Analysis of Correlations

The Associations Between Physician-Patient Communication and Adjustment Outcomes of Patients and Physicians: A Systematic Review and Meta-Analysis of Correlations

Global Burden, Regional Differences, Trends, and Health Consequences of Medication Nonadherence for Hypertension During 2010 to 2020: A Meta‐Analysis Involving 27 Million Patients

The impact of doctor–patient communication on medication adherence and blood pressure control in patients with hypertension: a systematic review

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