National High Blood Pressure Education Program (NHBPEP) Physician's Guide. Improving Adherence among Hypertensive Patients. The Working Group on Health Education and High Blood Pressure Control

摘要

Many physicians face the problem of nonadherence among their hypertensive patients. In fact, about half of all treated hypertensive patients discontinue their therapy within 1 year. Of those who continue treatment, less than half adhere to treatment sufficiently to achieve long-term control of their high blood pressure. Nationwide, more hypertensive patients than ever before are being diagnosed and receiving initial therapy for their lifelong condition. But adherence rates - patients who adhere to therapy for more than a few years and succeed in reaching goal blood pressure - continue to lag behind rates for awareness, detection, and initiation of therapy. As of 1980, just under 35 percent of treated patients had their blood pressure under control. Often, both physicians and patients know exactly what needs to be done. But after months of return visits, the desired reduction in blood pressure has not been achieved. During initial therapy, patients can be frustrated to find that blood pressure reduction is gradual, not dramatic, and that complex behavior changes are involved. The purpose of this guide is to help practitioners manage the problem of inadequate adherence to treatment and followup. The approach presented emphasizes actions and systems under your control that can increase the proportion of your hypertensive patients who reach goal blood pressure and who keep their pressure under control.