Getting the message across: opportunities and obstacles in effective communication in hypertension care

Effective communication is a prerequisite for any successful encounter between patient and provider. Nevertheless, it is unclear how/where communication can impact/affect adherence to antihypertensive medication, and maintenance of lifestyle changes to control blood pressure targets. Poor physician communication is correlated with a higher risk of treatment nonadherence. Given the high rates of hypertension globally, this review serves to enlighten aspects of the communication exchange from a provider, context, and patient perspective. Relevant articles were analyzed to assess barriers, solutions, and optimizations for communication with hypertensive patients. To support the findings, a model of communication in the context of hypertension treatment is presented, which comprises three phases: comprehension and acceptance, translation into action, and long-term retention. Secondly, an analysis of care providers (bedside manner, verbal/nonverbal communication, empathy and sex, time, knowledge base), context (format and tailoring of the message, and physical environment), and patient-related factors (sex, socio-economic status, language and health literacy, culture, age, psychological factors) were assessed in relation to hypertension. Current literature is limited regarding reciprocal communication, adaptive packaging of messages, and active verification of effective communication. To improve communication, hypertension care programs could benefit from better communication training, more team-based approaches, and flexible tools based on information technology.