Key result
Each one-point increase in Hill-Bone compliance score is linked to ~35% higher odds of controlled BP.
Why the study?
To evaluate antihypertensive therapy adherence and validate the Hill-Bone Compliance to High Blood Pressure Therapy Scale for clinical implementation in Romanian cardiology outpatient practice.
Does the Romanian-translated Hill-Bone Compliance to High Blood Pressure Therapy Scale (HBCTS) accurately assess antihypertensive adherence and correlate with blood pressure control in adult hypertensive outpatients?
Cross-Sectional (n=144)
No
Does the Romanian-translated Hill-Bone Compliance to High Blood Pressure Therapy Scale (HBCTS) accurately assess antihypertensive adherence and correlate with blood pressure control in adult hypertensive outpatients?
Effect estimate: OR 1.35 (95% CI 1.19-1.53)
p-value: p=<0.001
The Romanian-translated HBCTS is a valid and reliable tool for assessing antihypertensive medication adherence in outpatient cardiology settings, with higher scores significantly predicting better blood pressure control.
Supports HBCTS for adherence assessment in Romanian outpatients; leaves open whether scale-guided interventions improve BP control.
Purpose: To evaluate antihypertensive therapy adherence and to validate the Hill-Bone Compliance to High Blood Pressure Therapy Scale (HBCTS) for implementation in Romanian cardiology outpatient practice. Patients and Methods: In this cross-sectional pilot study, 144 adult hypertensive patients completed a Romanian-translated, culturally adapted HBCTS. Mean arterial pressure (MAP) served as an indicator of blood pressure control. Receiver operating characteristic (ROC) analysis determined the optimal adherence cut-off, and multivariable modelling assessed the relationship between HBCTS scores and MAP, adjusting for potential confounders. This study was conducted at an outpatient cardiology clinic in Targu Mureș, Romania, Patients inclusion criteria: adult patients (≥18 years) with diagnosed primary hypertension receiving at least one year of continuous antihypertensive therapy, and exclusion criteria: cognitive/communication barriers and secondary hypertension. Results: The HBCTS demonstrated acceptable internal consistency (McDonald's ω = 0.75; Cronbach's α = 0.70) and retained a three-factor structure. ROC analysis identified 50 points as the optimal adherence threshold (AUC = 0.81; sensitivity = 0.83; specificity = 0.57). After adjustment, 52.1% of participants met the adherence criterion. Each one-point increase in HBCTS score corresponded to a 35% increase in the odds of achieving controlled blood pressure (OR = 1.35; 95% CI: 1.19-1.53; p < 0.001). Older age was associated with lower probability of adherence (OR = 0.94; 95% CI: 0.89-0.98, p = 0.006), whereas permanent employment status increased the chance of higher adherence (OR = 3.36; 95% CI: 1.57-7.22, p = 0.002). Patients overreported their adherence by 18.5% compared with MAP-defined blood pressure control. Conclusion: These findings support the applicability of the HBCTS in Romanian cardiology outpatient settings and identify key demographic factors associated with patient's adherence. The validated scale offers cardiology practitioners a reliable instrument to detect adherence barriers among high-risk patients, thereby supporting the implementation of targeted, patient-centered interventions.
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Tătar et al. (2025) conducted a cross-sectional in Primary hypertension (n=144). Hill-Bone Compliance to High Blood Pressure Therapy Scale (HBCTS) was evaluated on Controlled blood pressure (MAP < 100 mmHg) (OR 1.35, 95% CI 1.19-1.53, p=<0.001). Each one-point increase in the Hill-Bone Compliance to High Blood Pressure Therapy Scale score was associated with a 35% increase in the odds of achieving controlled blood pressure (OR 1.35).
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