Stream-lined tactics for improving antihypertensive medication adherence and BP control
| Prescribing related tactics (high-level clinician control) | Patient management (moderate clinician control) | Healthcare system, policy, and payment-related (limited clinician control) |
|---|---|---|
| SPCs for initial and long-term therapy | Rigorous measurement of office BP including AOBP with validated devices | Available and affordable SPC |
| Longer days of supply, especially for maintenance therapy (90 vs. 30 days) | SMBP training with relay of BP data to care team with patient advice and support | Infrastructure and payment for efficient SMBP with relay and advice/support |
| Rx intensification, especially adding BP med within an SPC or concurrent dose increase of 2–3 meds in SPC at encounters with uncontrolled BP | Monthly encounters until BP controlled | Patient-centered, team-based care with payment for quality |
| Refill consolidation, especially when multiple chronic conditions | Teach back, pill organizers, apps tailored to patient needs | Available and affordable objective measures of adherence |
BP: blood pressure; SPCs: single-pill combinations; SMBP: self-measured BP; AOBP: automated office BP