Compliance With Antihypertensive Regimen: A Review of the Research in the 1980s

Abstract Over the past two decades, the health care community and the National Institutes of Health have focused attention toward the control of hypertension. Although considerable research has been undertaken which contributes to our understanding of compliance, little has been achieved in improved self-care by patients. This review highlights the past decade of published research related to compliance with hypertension regimens. The focus of the review is on the extent of the problem of noncompliance, setting differences in compliance rates, measurement influences on compliance rates, research on compliance measurement methods, medication compliance, and intervention strategies to improve patient compliance. At the close of the 1970s, it was noted that determinants of compliance were complex and poorly understood. Continuing research efforts on the extent of noncompliance suggest that improvements have not been made in the 1980s; however, the research does suggest directions for a better understanding of compliance and its modifications. The research suggests that differences exist in compliance rates between treatment settings, and that compliance can be enhanced by support networks. Studies of noncompliance, however, have generally not yielded new insights. The research suggests that the inclusion of cognitive constructions of illness may strengthen the effect of behavioral interventions. Research has also progressed on the validation of measures of compliance. Continued research emphasizing the development of measures with enhanced reliability and accuracy would advance the field. The research of the past decade suggests there are a number of promising avenues yet to be explored.