Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Robert C. Byrd Health Sciences Center [North], Morgantown, WV, USA.
Transl Behav Med. 2020 Oct 12;10(5):1177-1186. doi: 10.1093/tbm/ibaa020.
Medication adherence is a major problem in the treatment of hypertension. Approximately half of the patients who use antihypertensive medications are not adherent. Several interventions have endeavored to improve medication adherence among patients with hypertension, and some have used health behavioral models/theories. However, the quality and effectiveness of using health behavioral models/theories in improving medication adherence among patients with hypertension remain unknown. The main aim of this systematic review was to describe study characteristics and types of health behavioral models/theories used in interventions for improving medication adherence among adults with hypertension. PubMed, Scopus, Ovid MEDLINE, CINAHL, and PsycINFO databases were searched for randomized clinical trial interventions using any health behavioral models/theories published in English from 1979 to 2019. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two independent reviewers searched, screened abstracts and articles, extracted data, and assessed the risk of bias and the use of the model/theory using the Theory Coding Scheme. A total of 11 articles were included in this systematic review. Two studies reported significant improvement in medication adherence. The Self-Regulation Model and Social Cognitive Theory were the most common types of models/theories. Nine studies used a single model/theory, and four studies measured the constructs of a model/theory. Risk of bias was good (n = 4) and fair (n = 5) in interventions. Using health behavioral models/theories may be an efficient way for health care professionals to improve adherence to medications among patients with hypertension. More interventions with rigorous designs are needed that appropriately utilize health behavioral models/theories for improving medication adherence among adults with hypertension.
药物治疗依从性是高血压治疗中的一个主要问题。大约一半使用抗高血压药物的患者不依从。已经有一些干预措施致力于提高高血压患者的药物治疗依从性，其中一些措施还使用了健康行为模式/理论。然而，在提高高血压患者药物治疗依从性方面使用健康行为模式/理论的质量和效果仍不清楚。本系统评价的主要目的是描述干预措施中使用的健康行为模式/理论的研究特征和类型，以提高成年高血压患者的药物治疗依从性。从 1979 年到 2019 年，使用健康行为模式/理论的随机临床试验干预措施，在 PubMed、Scopus、Ovid MEDLINE、CINAHL 和 PsycINFO 数据库中以英文发表的文章都进行了检索。根据系统评价和荟萃分析的首选报告项目指南，两名独立审查员搜索、筛选摘要和文章、提取数据，并使用理论编码方案评估偏倚风险和模型/理论的使用情况。本系统评价共纳入 11 篇文章。有两项研究报告药物治疗依从性有显著改善。自我调节模型和社会认知理论是最常见的模式/理论类型。有 9 项研究使用了单一模型/理论，4 项研究测量了模型/理论的结构。干预措施的偏倚风险为良好（n = 4）和中等（n = 5）。使用健康行为模式/理论可能是医疗保健专业人员提高高血压患者药物治疗依从性的有效方法。需要更多设计严谨的干预措施，适当利用健康行为模式/理论来提高成年高血压患者的药物治疗依从性。
