Therapeutic adherence in hypertension: Current evidence and expert opinion from India
Jamshed Dalal, Prafulla Kerkar, Santanu Guha, Arup Dasbiswas, J.P.S. Sawhney, N. Sivakadaksham, Srinivasa Rao Maddury, Amit Kumar, Nishith Chandra, Gulla Suryaprakash, Joy M Thomas, Nazir Juvale, Sunil Sathe, Aziz Khan, Sandeep Bansal, Viveka Kumar, Rajshekhar Reddi
Abstract
Hypertension (HTN) is a globally prevalent non-communicable disease contributing significantly to cardiovascular (CV) morbidity and mortality. In achieving control of HTN, therapeutic adherence plays a crucial role. Studies from India identify varying rates of adherence to antihypertensive medications. Multiple factors determine treatment adherence in HTN. In India, factors such as lower socioeconomic status, health literacy, asymptomatic nature of disease, forgetfulness, cost of medications, and duration of HTN determine the adherence. An excellent physician-patient relationship incorporating adequate counseling along with the use of other methods can identify poor adherence. Improving adherence necessitates incorporating a multipronged approach with strategies directed at physicians, patients, and health systems. With innovation in therapeutics, the pharmaceutical sector can contribute significantly to improve adherence. Furthermore, increasing adherence to lifestyle interventions can help achieve better HTN control and improve CV outcomes. In the Indian context, more emphasis is necessary on patient education, enhanced physician-patient relationship and communication, increased access to health care, and affordability in improving therapeutic adherence in HTN.