Review: simplifying dosing regimens appears to improve treatment adherence in patients with high blooa pressure in ambulatory settings

摘要

The review by Schroeder et al assesses the effects of strategies for improving adherence to medication and blood pressure control (including simplifying dosing regimens) in patients with hypertension. The findings will be of interest to nurses in ambulatory settings who care for patients on oral antihypertensive medications.The data sources and study selection process enhance the likelihood that the review includes the most relevant studies. Exclusion criteria limit the generalisability of the results to ambulatory settings and patients with primary hypertension. The review did not examine drug interactions, side effects, or costs in relation to level of adherence or level of blood pressure control.The authors conclude that in ambulatory settings, simplifying dosing regimens increases adherence to blood pressure lowering medication in patients with high blood pressure but that the effect on subsequent blood pressure levels is unclear. More evidence is required to determine if motivational strategies and complex interventions are as effective for improving treatment adherence. The finding that patient education alone does not promote adherence has a direct impact on nursing practice. Nurses will need to combine educational interventions with other strategies and continue to assess the effects of their approaches on both adherence and blood pressure levels.Treatment with antihypertensive medication is an important component of multi-interventional blood pressure management and cardiovascular risk reduction care plans.The review by Schroeder et al strengthens the position that simplifying antihypertensive dosing regimens can lead to improved medication adherence in patients with primary hypertension who access care through ambulatory settings.