Key result
Theory-based interventions improve medication adherence in ~60% of hypertension trials.
Why the study?
Few interventions to enhance antihypertensive adherence have utilized health behavioral theories, and the research quality and efficacy of these theory-based studies remain undetermined.
Do theory-based interventions improve medication adherence in adult patients with hypertension in primary healthcare and community settings?
Systematic Review (n=3,485)
Do theory-based interventions improve medication adherence in adult patients with hypertension in primary healthcare and community settings?
Theory-based interventions, particularly those using Social Cognitive Theory and Motivational Interviewing, may enhance medication adherence in patients with hypertension, though the evidence is limited by the high risk of bias in several studies.
May support theory-based adherence programs in hypertension; extends RCT data but high bias leaves practice change open.
OBJECTIVES: Numerous interventions have been implemented to enhance adherence to antihypertensive medications, yet only a few have utilized health behavioral theories. The research quality and efficacy of these theory-based studies remain undetermined. This systematic review aimed to provide a thorough description of research that employed health behavior theories to improve medication adherence in patients diagnosed with hypertension, particularly in primary healthcare and community settings. METHODS: PubMed and Scopus were searched for randomized clinical trials that employed health behavioral theories to improve medication adherence in patients with hypertension, published in English between 2013 and 2023. Data were extracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Joanna Briggs Institute critical appraisal tool was used to evaluate the risk of bias. RESULTS: Of the 446 studies initially identified, only 10 met the inclusion criteria and were included in this systematic review. Eight studies employed a single theory, and 2 applied a combination of theories, with Social Cognitive Theory and the Transtheoretical Model being the most predominant. Six trials demonstrated a notable enhancement in medication adherence, while 5 studies were assessed to have a high risk of bias. CONCLUSIONS: Although not all studies employed a complete theoretical framework, the majority indicate that utilizing theory can enhance medication adherence.
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Yulianti et al. (2025) conducted a systematic review in Hypertension (n=3,485). Theory-based interventions vs. Routine treatment or usual care was evaluated on Medication adherence. Theory-based interventions, predominantly utilizing Social Cognitive Theory and the Transtheoretical Model, improved medication adherence in 6 out of 10 included randomized controlled trials among patients with hypertension.
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