Main Factors That Determine Adherence to Pharmacological Treatment in Hypertensive Patients. Systematic Review

Abstract

Objective:To determine through the systematic review which are the factors that determine adherence to pharmacological treatment in hypertensive patients.Design and method:Systematic review with the terms DeCS and MeSH: Medication adherence, treatment adherence, medication compliance, hypertension, hypertensive patients, factors associated, in different databases. We included cohort studies and systematic review studies. Articles were assessed at risk of bias, with the help of critical and methodological guidelines STROBE and Prism, and level of evidence (CEBM)Results:The factors associated with pharmacological adherence were: age greater than 45 years, greater knowledge of the disease, treatment and therapeutic adherence, high levels of self-efficacy and / or recognize low level of barriers, the factors associated with pharmacological non-adherence were: lower economic income, age less than 35 years, difficulty accessing health care, not having adequate follow-up of the disease, prescription of more than two types of antihypertensive drugs, diagnosis of hypertension less than 5 years, deficiency of knowledge of the disease, treatment and adherence, not trusting in the treatment or using alternative, complementary or traditional medicine.Conclusions:High blood pressure is a global public health problem associated with an increased risk of developing cardiovascular disease, which requires lifelong treatment. The main consequence of suffering from hypertension is the development of complications that deteriorate the patient’s quality of life and inevitably cause death. Therefore, adherence to pharmacological treatment is essential in the treatment of chronic diseases, particularly hypertension, the identification and understanding of the factors that modify adherence to treatment is key to adapt a better control of hypertensive patients. The findings of existing studies should be interpreted with caution due to their methodological limitations. The results of this study confirm that pharmacological adherence to the treatment of hypertension is due to a multiplicity of factors, such as: socioeconomic factors, related to access to health systems, therapy, related to the condition and the patient. Since some of these factors are modifiable, they may be the focus of interventions to increase medication adherence.