Understanding the role of educational interventions on medication adherence in hypertension: A systematic review and meta-analysis

Background: Medication adherence among patients with hypertension has continued to be a challenge despite various educational interventions utilised in their care. The effect of the different educational methods on medication adherence in hypertension remains uncertain. Objectives: To examine the effect of educational interventions on improving medication adherence among patients with hypertension. Methods: A systematic search was conducted using EMBASE, MEDLINE, PsycINFO, CINHAL, PUBMED, HTA and Cochrane controlled trial registry from 1999 to 2019. Subgroup analysis was performed according to the various methods of educational intervention. Results: Twelve studies identified from seven databases were interrogated. There was a low to moderate quality evidence to support the improvement of medication adherence with educational interventions. Verbal education had a small statistically significant effect d = 0.18 (95% CI 0.01-0.34, p < 0.04). No statistically significant difference was found between bimodal (verbal and printed) and multimodal (verbal, printed and electronic) educational interventions. Frequent contacts during patient education showed better outcomes of medication adherence. Conclusions: Verbal educational interventions can improve health literacy and consequent adherence to medication among individuals with hypertension. Frequent verbal educational interventions can enhance patient engagement, participation as well as promote medication literacy and adherence. Healthcare professionals should adopt innovative ways of ensuring regular follow-ups and making educational sessions more interactive and useful to patients. (C) 2020 Elsevier Inc. All rights reserved.