A study published in the BMJ analysed 59 papers reporting on 53 qualitative studies of people with hypertension from 16 countries.
A team from King’s College London found that non-adherence to hypertension treatment was often a result of patients’ views of the causes and effects of hypertension.
Participants frequently identified stress as a cause, an exacerbating factor and a consequence of hypertension. From a medical perspective, stress plays a small part in hypertension.
Deliberately choosing to avoid or reduce treatment was a recurring theme in many of the studies. Participants reported intentionally missing and adjusting doses due to a fear of adverse effects or in order to avoid addiction.
Research shows that participants unintentionally missed doses due to other commitments, the costs of drugs and, in the United States, not having health insurance.
The research found that calls for culturally specific education on hypertension were not justified, because principal themes in the studies were remarkably similar across geographical and ethnic groups.
The researchers said: ‘To improve adherence, clinicians and educational interventions must better understand and engage with patients’ ideas about causality, experiences of symptoms, and concerns about drug side-effects.'