MODULE 4: Enhancing Adherence with Antihypertensives: The Role of Fixed-Dose Combinations and Home Blood Pressure Monitoring

A more recent trial in 57 patients, 38 of whom measured their BP at home and 19 of whom received usual care, found greater medication adherence in the HBPM group than in the control group (100% vs 88%, P < .031). The HBPM group also reached their treatment goals significantly faster than the control group (P = .02).³⁶

Conclusion

Approximately 50% of individuals with hypertension who receive antihypertensive medication still do not reach their BP goal. One reason is nonadherence to medication, which is often related to treatment complexity, or pill burden. Given that most patients with hypertension will require more than 1 drug to manage their blood pressure, it is important that clinicians identify opportunities to simplify treatment. This may include fixed-dose combination therapy, which can improve adherence, as well as additional education regarding the efficacy and adverse effects of therapy.

The use of HBPM may also improve adherence by providing frequent feedback on treatment effectiveness.

It is important, however, that clinicians understand that no single approach to adherence will work for every patient. The greatest success comes with combining several approaches based on the barriers that affect each individual patient.