Yulianti Tri, Widayanti Anna Wahyuni, Kristina Susi Ari, Yasin Nanang Munif
Doctoral Program in Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Muhammadiyah Surakarta, Surakarta, Indonesia.
J Prev Med Public Health. 2025 Jul;58(4):348-359. doi: 10.3961/jpmph.24.651. Epub 2025 Feb 17.
Numerous interventions have been implemented to enhance adherence to antihypertensive medications, yet only a few have utilized health behavioral theories. The research quality and efficacy of these theory-based studies remain undetermined. This systematic review aimed to provide a thorough description of research that employed health behavior theories to improve medication adherence in patients diagnosed with hypertension, particularly in primary healthcare and community settings.
PubMed and Scopus were searched for randomized clinical trials that employed health behavioral theories to improve medication adherence in patients with hypertension, published in English between 2013 and 2023. Data were extracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Joanna Briggs Institute critical appraisal tool was used to evaluate the risk of bias.
Of the 446 studies initially identified, only 10 met the inclusion criteria and were included in this systematic review. Eight studies employed a single theory, and 2 applied a combination of theories, with Social Cognitive Theory and the Transtheoretical Model being the most predominant. Six trials demonstrated a notable enhancement in medication adherence, while 5 studies were assessed to have a high risk of bias.
Although not all studies employed a complete theoretical framework, the majority indicate that utilizing theory can enhance medication adherence.
已实施了多种干预措施以提高抗高血压药物的依从性，但只有少数措施运用了健康行为理论。这些基于理论的研究的研究质量和疗效仍未确定。本系统评价旨在全面描述运用健康行为理论提高高血压患者药物依从性的研究，特别是在初级医疗保健和社区环境中的研究。
在PubMed和Scopus数据库中检索2013年至2023年期间发表的、运用健康行为理论提高高血压患者药物依从性的随机临床试验。按照系统评价和Meta分析的首选报告项目（PRISMA）指南提取数据。使用乔安娜·布里格斯研究所的批判性评价工具评估偏倚风险。
在最初识别的446项研究中，只有10项符合纳入标准并被纳入本系统评价。8项研究采用单一理论，2项研究应用了多种理论的组合，其中社会认知理论和跨理论模型最为突出。6项试验表明药物依从性有显著提高，而5项研究被评估为存在高偏倚风险。
虽然并非所有研究都采用了完整的理论框架，但大多数研究表明运用理论可以提高药物依从性。
