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Scalable low-cost interventions to support medication adherence in people prescribed treatment for hypertension in primary care: a research programme

  • Stephen Sutton
  • , Katja Beardsell
  • , Debi Bhattacharya
  • , James Brimicombe
  • , Gianna Cadorna
  • , Raquel Conceição
  • , Anna De Simoni
  • , Helen Eborall
  • , Simon Griffin
  • , Pankaj Gupta
  • , Wendy Hardeman
  • , Kevin Herbert
  • , James Jamison
  • , Jonathan Mant
  • , Cecilia Mascolo
  • , Efthalia Massou
  • , Richard J McManus
  • , Venus Mirzaei
  • , Stephen Morris
  • , Felix Naughton
  • Prashanth Patel, Andrew Toby Prevost, Sonia Shpendi, Amrit Takhar, Catalina Trama Alvarez, Miranda Van Emmenis, Joana Carvalho de Vasconcelos, Anamarija Veic

Research output: Contribution to journalArticlepeer-review

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Abstract

Background: About 14.9% of people (9.9 million) registered with primary care practices in England and Wales are prescribed medication for hypertension. However, many do not take their medication as prescribed. To address this
problem, we need scalable interventions.

Objective: To develop a scalable low-cost intervention to support medication adherence in people prescribed medication for hypertension in primary care, and to obtain precise and robust estimates of the effectiveness and cost
effectiveness of the intervention compared with usual care.

Design: Systematic reviews and meta-analyses; qualitative meta-synthesis; interviews and focus groups; expert consultations; pre-testing study; randomised feasibility trial; randomised controlled trial of effectiveness and cost
effectiveness; economic modelling.

Setting and participants: Primary care practices in England and Wales. Patients prescribed medication for hypertension with poorly controlled blood pressure.

Interventions: Very brief intervention delivered by a practice nurse or healthcare assistant followed by a digital intervention (text messaging programme or smartphone app).

Main outcome measures: Acceptability, feasibility, fidelity and cost of the interventions. Systolic blood pressure. Biochemical and self-reported measures of medication adherence.

Results: Our systematic reviews showed that both app-based and face-to-face interventions in patients with long-term conditions have a positive effect on medication adherence.
Original languageEnglish
Pages (from-to)1-46
JournalProgramme Grants for Applied Research
Volume14
Issue number18
DOIs
Publication statusPublished - 6 Aug 2026

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