Interventions to Improve Medication Adherence in People With Hypertension: Protocol for a Systematic Review and...

Medication adherence is the extent to which a patient's behavior corresponds with the prescriber's recommendations for taking medications. Non-adherence is particularly high in patients with hypertension, leading to poor blood pressure control, increased cardiovascular risk, and increased burden on the healthcare system. A multitude of techniques and interventions to measure and improve medication adherence have been evaluated with mixed results. This protocol outlines a systematic review and meta-analysis of randomized controlled trials evaluating interventions aimed at improving medication adherence in people with hypertension. There will be a focus on investigating intervention impact on the duration of medication adherence, persistence, analysis of subjective versus objective medication adherence measurement techniques, the impact of patient demographics on intervention effectiveness, and the use of the Behavior Change Taxonomy to categorize behavior change interventions and facilitate their evaluation.

This protocol was developed using the PRISMA-P checklist and prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42024614468). A comprehensive literature search was conducted using Medline (Ovid), CINAHL and Embase electronic databases for articles published from inception to November 27th, 2024. In addition, CENTRAL was searched for articles published up to the end of 2024. Fixed and/or random-effects meta-analysis will be used as appropriate, according to between study heterogeneity, and the risk of bias of included studies will be assessed using the Cochrane risk of bias tool.

The results and findings of this review will be reported in accordance with PRISMA guidelines and published in a peer-reviewed journal.

The findings of this review will evaluate the evidence for interventions designed to improve medication adherence in people with hypertension. The results will provide evidence on which adherence interventions, or components of complex interventions, are effective and how they impact blood pressure control. Recommendations will be made for further research, including the design of interventions and methodology for medication adherence measurement.