Hypertension healthcare professional beliefs and behaviour regarding patient medication adherence: a survey conducted among European Society of Hypertension Centres of Excellence

Abstract

Purpose: Little is known on the beliefs, perceptions and practices of hypertension specialists in addressing non-adherence to therapy. Therefore, a survey was undertaken amongst healthcare professionals (HCPs) managing hypertension in the European Society of Hypertension (ESH) Centres of Excellence. Materials and methods: Cross-sectional data were obtained between December 2020 and April 2021 using an online anonymous structured questionnaire including 26 questions/136 items, that was sent to all ESH Excellence centres. Results: Overall 67 from 187 centres (37.3%) responded and 200 HCPs from 30 countries answered the questionnaire. Participants (60% men) were mainly physicians (91%) and nurses (8%) from University hospitals (77%). Among physicians, 83% had >10 years professional experience. Average time dedicated to discuss medications was 1-5 min in 48% and 6-10 min in 29% of cases. Interviews with patients about adherence were the most frequently used assessment method. Chemical detection of medications in urine was available in 36% of centres. One third of physicians involved their patients regularly in treatment decisions. The most frequent methods to improve adherence included simplification of medication therapy, more frequent visits, and home blood pressure monitoring. Conclusions: The level of implementation of tools to detect and improve adherence in hypertension management by HCPs in ESH excellence centres is low. Structured educational activities focussing on adherence management and access to the newest objective measures to detect non-adherence might improve these deficits.

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“…The importance of these centers can be illustrated by the Hypertension Excellence Centers that have been established by ESH throughout Europe, fulfilling prespecified criteria regarding the ability to provide multidisciplinary services and offer high-quality inpatient and outpatient care [1717]. These centers are also contributing to clinical hypertension research, and thereby contributing to the advances of knowledge in the field [1614,1718].…”

Therapeutic roles of plants for 15 hypothesised causal bases of Alzheimer’s disease

“…However, there is an incidence of adverse drug effects and adverse other outcomes [ 301 ]. A major issue is adherence with treatment (global average < 50%) [ 302 ]. Prospectively such limitations may be ameliorated by the many plants demonstrating anti-hypertensive activity.…”

Opinions on hypertension care and therapy adherence at the healthcare provider and healthcare system level: a qualitative study in the Hague, Netherlands

“…Barriers for addressing adherence were: identification of non-adherent patients, time of consultation, high workload, lack of continuity of hypertensive care and inadequate resources. 25 In this study, we wanted to gain more in depth insight in healthcare providers' beliefs regarding current healthcare for people with hypertension or about their beliefs concerning therapy adherence. Our goal was, therefore, to explore facilitators and barriers in healthcare in order to identify determinants, at the level of both the healthcare provider and the healthcare system, which can be modified in order to improve therapy adherence in people with hypertension.…”

“…Barriers for addressing adherence were: identification of non-adherent patients, time of consultation, high workload, lack of continuity of hypertensive care and inadequate resources. 25 …”