Vol 28 (2024): Continuous Publishing
Guidelines / Expert consensus
Published online: 2024-11-26

open access

Page views 79
Article views/downloads 45
Get Citation

Connect on Social Media

Connect on Social Media

Physician–patient partnership — can it help increase adherence to the therapeutic recommendations in cardiovascular disease?

Piotr Dobrowolski1, Aleksander Prejbisz1, Anna Szyndler2, Agnieszka Olszanecka3, Agnieszka Kapłon-Cieślicka4, Marcin Wełnicki5, Piotr Jankowski6, Krzysztof Narkiewicz2, Jacek Wolf2
DOI: 10.5603/ah.103488
Arterial Hypertension 2024;28:50-70.

Abstract

Position statement of the Polish Society of Hypertension and Working Group on Cardiovascular Pharmacotherapy, Polish Cardiac Society endorsed by patient advocacy groups (1) We Patients Foundation, (2) The Institute for Patients’ Rights and Health Education, (3) The National Association of Patients with Heart and Vascular Conditions “EcoHeart/EcoSerce”

 

Efforts to increase adherence to the therapeutic recommendations in primary and secondary prevention of cardiovascular disease include focuses on the improvement of communication between patients and physicians. Physicians need to promote patients’ education and combat disinformation available on the Internet. Use of the electronic methods (e.g., SMS reminders/prompts), elimination of economic barriers, and monitoring of adherence may be also of help. With relation to pharmacotherapy, simplification of drug regimens with wide use single-pill combinations (SPCs) may provide effective measure to substantially improve adherence. Only comprehensive efforts to improve adherence by building a partner patient-physician relationship, may contribute to an increase in persistence and lead to reduction of cardiovascular morbidity and mortality in the general population.

Article available in PDF format

View PDF Download PDF file

References

  1. Laufs U, Rettig-Ewen V, Böhm M. Strategies to improve drug adherence. Eur Heart J. 2011; 32(3): 264–268.
  2. Institut Sapiens (2023), Améliorer l’adhésion thérapeutique: un enjeu de santé publique. https://www.institutsapiens.fr/wp-content/uploads/2023/06/Ameliorer-ladhesion-therapeutique-V1.pdf..
  3. Seaman K, Sanfilippo F, Bulsara M, et al. Increased risk of 2-year death in patients who discontinued their use of statins. J Health Serv Res Policy. 2021; 26(2): 95–105.
  4. Kim CL, Do YS, Kim BJ, et al. Clinical impact of medication adherence on 10-year cardio-cerebrovascular mortality in newly diagnosed hypertensive patients. J Clin Hypertens (Greenwich). 2021; 23(9): 1695–1702.
  5. Lee H, Yano Y, Cho SoM, et al. Adherence to Antihypertensive Medication and Incident Cardiovascular Events in Young Adults With Hypertension. Hypertension. 2021; 77(4): 1341–1349.
  6. Nielsen SF, Nordestgaard BG. Negative statin-related news stories decrease statin persistence and increase myocardial infarction and cardiovascular mortality: a nationwide prospective cohort study. Eur Heart J. 2016; 37(11): 908–916.
  7. Mancia G, Kreutz R, Brunström M, et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens. 2023; 41(12): 1874–2071.
  8. Vrijens B, De Geest S, Hughes DA, et al. ABC Project Team. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol. 2012; 73(5): 691–705.
  9. Aronson JK. Time to abandon the term ‘patient concordance’. Br J Clin Pharmacol. 2007; 64(5): 711–713.
  10. WHO. Adherence to long-term therapies: evidence for action. World Health Organization, Geneva, 9241545992, 2003 2003. https://iris.who.int/handle/10665/42682.
  11. R. Horne et al. Concordance, adherence and compliance in medicine taking. Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO). 2005. https://www.ahpo.net/assets/NCCSDO%20Compliance%202005.pdf.
  12. Elwyn G, Frosch D, Thomson R, et al. Shared decision making: a model for clinical practice. J Gen Intern Med. 2012; 27(10): 1361–1367.
  13. Meddings J, Kerr EA, Heisler M, et al. Physician assessments of medication adherence and decisions to intensify medications for patients with uncontrolled blood pressure: still no better than a coin toss. BMC Health Serv Res. 2012; 12: 270.
  14. NFZ o zdrowiu. Nadciśnienie tętnicze. Warszawa 2019. https://www.nfz.gov.pl/download/gfx/nfz/pl/defaultstronaopisowa/349/44/1/nadcisnienie-tetnicze-raport-nfz-2019-small.pdf.
  15. Mackenzie IS, Hawkey CJ, Ford I, et al. ALL-HEART Study Group. Allopurinol versus usual care in UK patients with ischaemic heart disease (ALL-HEART): a multicentre, prospective, randomised, open-label, blinded-endpoint trial. Lancet. 2022; 400(10359): 1195–1205.
  16. Eskås PA, Heimark S, Eek Mariampillai J, et al. Adherence to medication and drug monitoring in apparent treatment-resistant hypertension. Blood Press. 2016; 25(4): 199–205.
  17. Garfield S, Clifford S, Eliasson L, et al. Suitability of measures of self-reported medication adherence for routine clinical use: a systematic review. BMC Med Res Methodol. 2011; 11: 149.
  18. Cramer JA. How often is medication taken as prescribed? A novel assessment technique. JAMA. 1989; 261(22): 3273–3277.
  19. Burnier M, Schneider MP, Chioléro A, et al. Electronic compliance monitoring in resistant hypertension: the basis for rational therapeutic decisions. J Hypertens. 2001; 19(2): 335–341.
  20. Fadl Elmula FE, Hoffmann P, Fossum E, et al. Renal sympathetic denervation in patients with treatment-resistant hypertension after witnessed intake of medication before qualifying ambulatory blood pressure. Hypertension. 2013; 62(3): 526–532.
  21. Bunker J, Chang CL, Chapman N, et al. True Resistant Hypertension Following Observed Drug Ingestion: A Systematic Evaluation. J Clin Hypertens (Greenwich). 2017; 19(3): 250–255.
  22. Ho PM, Bryson CL, Rumsfeld JS. Medication adherence: its importance in cardiovascular outcomes. Circulation. 2009; 119(23): 3028–3035.
  23. Robberechts T, Stoenoiu MS, Burnier M, et al. Optimizing drug adherence in hypertension: More than a mind game. Kardiol Pol. 2024; 82(3): 259–266.
  24. Simpson SH, Eurich DT, Majumdar SR, et al. A meta-analysis of the association between adherence to drug therapy and mortality. BMJ. 2006; 333(7557): 15.
  25. Burnier M, Egan BM. Adherence in Hypertension. Circ Res. 2019; 124(7): 1124–1140.
  26. Vrijens B, Vincze G, Kristanto P, et al. Adherence to prescribed antihypertensive drug treatments: longitudinal study of electronically compiled dosing histories. BMJ. 2008; 336(7653): 1114–1117.
  27. Berra E, Azizi M, Capron A, et al. Evaluation of Adherence Should Become an Integral Part of Assessment of Patients With Apparently Treatment-Resistant Hypertension. Hypertension. 2016; 68(2): 297–306.
  28. Choudhry NK, Kronish IM, Vongpatanasin W, et al. American Heart Association Council on Hypertension; Council on Cardiovascular and Stroke Nursing; and Council on Clinical Cardiology. Medication Adherence and Blood Pressure Control: A Scientific Statement From the American Heart Association. Hypertension. 2022; 79(1): e1–e14.
  29. Parati G, Stergiou GS, Bilo G, et al. Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension. Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension. J Hypertens. 2021; 39(9): 1742–1767.
  30. Pathak A, Poulter NR, Kavanagh M, et al. Improving the Management of Hypertension by Tackling Awareness, Adherence, and Clinical Inertia: A Symposium Report. Am J Cardiovasc Drugs. 2022; 22(3): 251–261.
  31. Chaudri NA. Adherence to Long-term Therapies Evidence for Action. Ann Saudi Med. 2003; 24(3): 221–222.
  32. Parati G, Kjeldsen S, Coca A, et al. Adherence to Single-Pill Versus Free-Equivalent Combination Therapy in Hypertension: A Systematic Review and Meta-Analysis. Hypertension. 2021; 77(2): 692–705.
  33. Rea F, Savaré L, Franchi M, et al. Adherence to Treatment by Initial Antihypertensive Mono and Combination Therapies. Am J Hypertens. 2021; 34(10): 1083–1091.
  34. Shi Lu, Zhang D, Wang L, et al. Meditation and blood pressure: a meta-analysis of randomized clinical trials. J Hypertens. 2017; 35(4): 696–706.
  35. Schneider MP, Burnier M. Partnership between patients and interprofessional healthcare providers along the multifaceted journey to medication adherence. Br J Clin Pharmacol. 2023; 89(7): 1992–1995.
  36. Khan NA, Stergiou GS, Omboni S, et al. Virtual management of hypertension: lessons from the COVID-19 pandemic-International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension. J Hypertens. 2022; 40(8): 1435–1448.
  37. De Geest S, Sabaté E. Adherence to long-term therapies: evidence for action. Eur J Cardiovasc Nurs. 2003; 2(4): 323.
  38. McGuire LC. Remembering what the doctor said: organization and adults' memory for medical information. Exp Aging Res. 1996; 22(4): 403–428.
  39. Naughton CA. Patient-Centered Communication. Pharmacy (Basel). 2018; 6(1).
  40. Ryan R, Santesso N, Lowe D, et al. Interventions to improve safe and effective medicines use by consumers: an overview of systematic reviews. Cochrane Database Syst Rev. 2014; 2014(4): CD007768.
  41. Glynn LG, Murphy AW, Smith SM, et al. Interventions used to improve control of blood pressure in patients with hypertension. Cochrane Database Syst Rev. 2010(3): CD005182.
  42. Anderson L, Brown JPr, Clark AM, et al. Patient education in the management of coronary heart disease. Cochrane Database Syst Rev. 2017; 6(6): CD008895.
  43. Clyne W, McLachlan S, Mshelia C, et al. "My patients are better than yours": optimistic bias about patients' medication adherence by European health care professionals. Patient Prefer Adherence. 2016; 10: 1937–1944.
  44. Schroeder K, Fahey T, Ebrahim S. Interventions for improving adherence to treatment in patients with high blood pressure in ambulatory settings. Cochrane Database Syst Rev. 2004; 2004(2): CD004804.
  45. Mulder-Vos I, Driever EM, Brand PLP. Observational study on the timing and method of interruption by hospital consultants during the opening statement in outpatient consultations. BMJ Open. 2023; 13(9): e066678.
  46. Miller W, Rollnick S. Motivational interviewing: Helping people change. Guilford Press, New York, London 2012.
  47. Sacristán JA. Patient-centered medicine and patient-oriented research: improving health outcomes for individual patients. BMC Med Inform Decis Mak. 2013; 13: 6.
  48. Somani S, van Buchem MM, Sarraju A, et al. Artificial Intelligence-Enabled Analysis of Statin-Related Topics and Sentiments on Social Media. JAMA Netw Open. 2023; 6(4): e239747.
  49. Baigent C, Blackwell L, Emberson J, et al. Cholesterol Treatment Trialists’ (CTT) Collaboration. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010; 376(9753): 1670–1681.
  50. Fröbert O, Götberg M, Erlinge D, et al. Influenza Vaccination After Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial. Circulation. 2021; 144(18): 1476–1484.
  51. Slavin SD, Berman AN, Gaba P, et al. Influenza vaccination and use of lipid lowering therapies in adults with atherosclerotic cardiovascular disease: An analysis of the Behavioral Risk Factor Surveillance System (BRFSS). Am Heart J. 2024; 268: 1–8.
  52. Cholesterol Treatment Trialists' Collaboration. Effect of statin therapy on muscle symptoms: an individual participant data meta-analysis of large-scale, randomised, double-blind trials. Lancet. 2022; 400(10355): 832–845.
  53. Wood FA, Howard JP, Finegold JA, et al. N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects. N Engl J Med. 2020; 383(22): 2182–2184.
  54. Bogle BM, Ning H, Mehrotra S, et al. Lifetime Risk for Sudden Cardiac Death in the Community. J Am Heart Assoc. 2016; 5(7).
  55. Qvarnström M, Kahan T, Kieler H, et al. Persistence to antihypertensive drug treatment in Swedish primary healthcare. Eur J Clin Pharmacol. 2013; 69(11): 1955–1964.
  56. Hughes CM. Medication non-adherence in the elderly: how big is the problem? Drugs Aging. 2004; 21(12): 793–811.
  57. Elliott RA, Goeman D, Beanland C, et al. Ability of older people with dementia or cognitive impairment to manage medicine regimens: a narrative review. Curr Clin Pharmacol. 2015; 10(3): 213–221.
  58. Smith D, Lovell J, Weller C, et al. A systematic review of medication non-adherence in persons with dementia or cognitive impairment. PLoS One. 2017; 12(2): e0170651.
  59. Scuteri A, Spazzafumo L, Cipriani L, et al. Depression, hypertension, and comorbidity: disentangling their specific effect on disability and cognitive impairment in older subjects. Arch Gerontol Geriatr. 2011; 52(3): 253–257.
  60. Moise N, Davidson KW, Chaplin W, et al. Depression and clinical inertia in patients with uncontrolled hypertension. JAMA Intern Med. 2014; 174(5): 818–819.
  61. Madden JM, Graves AJ, Zhang F, et al. Cost-related medication nonadherence and spending on basic needs following implementation of Medicare Part D. JAMA. 2008; 299(16): 1922–1928.
  62. Visco V, Finelli R, Pascale AV, et al. Difficult-to-control hypertension: identification of clinical predictors and use of ICT-based integrated care to facilitate blood pressure control. J Hum Hypertens. 2018; 32(7): 467–476.
  63. Burnier M, Polychronopoulou E, Wuerzner G. Hypertension and Drug Adherence in the Elderly. Front Cardiovasc Med. 2020; 7: 49.
  64. Pagès-Puigdemont N, Tuneu L, Masip M, et al. Determinants of medication adherence among chronic patients from an urban area: a cross-sectional study. Eur J Public Health. 2019; 29(3): 419–424.
  65. Bandi P, Goldmann E, Parikh NS, et al. Age-Related Differences in Antihypertensive Medication Adherence in Hispanics: A Cross-Sectional Community-Based Survey in New York City, 2011-2012. Prev Chronic Dis. 2017; 14: E57.
  66. Weingarten MA, Cannon BS. Age as a major factor affecting adherence to medication for hypertension in a general practice population. Fam Pract. 1988; 5(4): 294–296.
  67. Kostev K, Yakkali B, Chaudhari S, et al. Persistence with first-line antihypertensive therapy in Germany: A retrospective cohort study with 2,801,469 patients. Int J Clin Pharmacol Therapeut. 2023; 61(05): 189–195.
  68. Ge L, Heng BH, Yap CW. Understanding reasons and determinants of medication non-adherence in community-dwelling adults: a cross-sectional study comparing young and older age groups. BMC Health Serv Res. 2023; 23(1): 905.
  69. Tajeu GS, Kent ST, Kronish IM, et al. Trends in Antihypertensive Medication Discontinuation and Low Adherence Among Medicare Beneficiaries Initiating Treatment From 2007 to 2012. Hypertension. 2016; 68(3): 565–575.
  70. Friedman O, McAlister FA, Yun L, et al. Canadian Hypertension Education Program Outcomes Research Taskforce. Antihypertensive drug persistence and compliance among newly treated elderly hypertensives in ontario. Am J Med. 2010; 123(2): 173–181.
  71. Yang Q, Chang A, Ritchey MD, et al. Antihypertensive Medication Adherence and Risk of Cardiovascular Disease Among Older Adults: A Population-Based Cohort Study. J Am Heart Assoc. 2017; 6(6).
  72. Consolazio D, Gattoni ME, Russo AG. Exploring gender differences in medication consumption and mortality in a cohort of hypertensive patients in Northern Italy. BMC Public Health. 2022; 22(1): 768.
  73. Rea F, Mella M, Monzio Compagnoni M, et al. Women discontinue antihypertensive drug therapy more than men. Evidence from an Italian population-based study. J Hypertens. 2020; 38(1): 142–149.
  74. Erkens JA, Panneman MMJ, Klungel OH, et al. Differences in antihypertensive drug persistence associated with drug class and gender: a PHARMO study. Pharmacoepidemiol Drug Saf. 2005; 14(11): 795–803.
  75. Kulkarni S, Rao R, Goodman JD, et al. Nonadherence to antihypertensive medications amongst patients with uncontrolled hypertension: A retrospective study. Medicine (Baltimore). 2021; 100(14): e24654.
  76. Biffi A, Rea F, Iannaccone T, et al. Sex differences in the adherence of antihypertensive drugs: a systematic review with meta-analyses. BMJ Open. 2020; 10(7): e036418.
  77. Polaczyk M, Olszanecka A, Wojciechowska W, et al. Multiple drug intolerance in patients with arterial hypertension: prevalence and determining factors. Pol Arch Intern Med. 2023; 133(3).
  78. Osude N, Durazo-Arvizu R, Markossian T, et al. Age and sex disparities in hypertension control: The multi-ethnic study of atherosclerosis (MESA). Am J Prev Cardiol. 2021; 8: 100230.
  79. Gu Q, Burt VL, Paulose-Ram R, et al. Gender differences in hypertension treatment, drug utilization patterns, and blood pressure control among US adults with hypertension: data from the National Health and Nutrition Examination Survey 1999-2004. Am J Hypertens. 2008; 21(7): 789–798.
  80. Marx N, Federici M, Schütt K, et al. ESC Scientific Document Group. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J. 2023; 44(39): 4043–4140.
  81. Tykarski A, Filipiak K, Januszewicz A, et al. 2019 Guidelines for the Management of Hypertension — Part 1–7. Arterial Hypertens. 2019; 23(2): 41–87.
  82. Szymański F, Mickiewicz A, Dzida G, et al. Leczenie dyslipidemii w Polsce — interdyscyplinarne stanowisko grupy ekspertów wsparte przez Sekcję Farmakoterapii Sercowo-Naczyniowej Polskiego Towarzystwa Kardiologicznego. IV Deklaracja Sopocka. Choroby Serca i Naczyń. 2021; 18(3): 95–120.
  83. Naderi SH, Bestwick JP, Wald DS. Adherence to drugs that prevent cardiovascular disease: meta-analysis on 376,162 patients. Am J Med. 2012; 125(9): 882–887.e1.
  84. Chowdhury R, Khan H, Heydon E, et al. Adherence to cardiovascular therapy: a meta-analysis of prevalence and clinical consequences. Eur Heart J. 2013; 34(38): 2940–2948.
  85. Castellano JM, Sanz G, Peñalvo JL, et al. A polypill strategy to improve adherence: results from the FOCUS project. J Am Coll Cardiol. 2014; 64(20): 2071–2082.
  86. Choudhry NK, Glynn RJ, Avorn J, et al. Untangling the relationship between medication adherence and post-myocardial infarction outcomes: medication adherence and clinical outcomes. Am Heart J. 2014; 167(1): 51–58.e5.
  87. Simons LA, Chung E, Ortiz M. Long-term persistence with single-pill, fixed-dose combination therapy versus two pills of amlodipine and perindopril for hypertension: Australian experience. Curr Med Res Opin. 2017; 33(10): 1783–1787.
  88. Weisser B, Predel HG, Gillessen A, et al. Single Pill Regimen Leads to Better Adherence and Clinical Outcome in Daily Practice in Patients Suffering from Hypertension and/or Dyslipidemia: Results of a Meta-Analysis. High Blood Press Cardiovasc Prev. 2020; 27(2): 157–164.
  89. Castellano JM, Pocock SJ, Bhatt DL, et al. SECURE Investigators. Polypill Strategy in Secondary Cardiovascular Prevention. N Engl J Med. 2022; 387(11): 967–977.
  90. Snyman JR, Bortolotto LA, Degli Esposti L, et al. A real-world analysis of outcomes and healthcare costs of patients on perindopril/indapamide/amlodipine single-pill vs. multiple-pill combination in Italy. J Hypertens. 2024; 42(1): 136–142.
  91. Rea F, Morabito G, Savaré L, et al. Adherence and related cardiovascular outcomes to single pill vs. separate pill administration of antihypertensive triple-combination therapy. J Hypertens. 2023; 41(9): 1466–1473.
  92. Van Wilder L, Devleesschauwer B, Clays E, et al. Polypharmacy and Health-Related Quality of Life/Psychological Distress Among Patients With Chronic Disease. Prev Chronic Dis. 2022; 19: E50.
  93. Chaudhry UAR, Wahlich C, Fortescue R, et al. The effects of step-count monitoring interventions on physical activity: systematic review and meta-analysis of community-based randomised controlled trials in adults. Int J Behav Nutr Phys Act. 2020; 17(1): 129.
  94. Qiu S, Cai X, Ju C, et al. Step Counter Use and Sedentary Time in Adults: A Meta-Analysis. Medicine (Baltimore). 2015; 94(35): e1412.
  95. Kaihara T, Intan-Goey V, Scherrenberg M, et al. Automatic transmission of home blood pressure data can be effective in managing hypertension: a systematic review and meta-analysis. Eur Heart J Digit Health. 2022; 3(4): 638–653.
  96. De Groot J, Wu D, Flynn D, et al. Efficacy of telemedicine on glycaemic control in patients with type 2 diabetes: A meta-analysis. World J Diabetes. 2021; 12(2): 170–197.
  97. Turan Kavradim S, Özer Z, Boz İ. Effectiveness of telehealth interventions as a part of secondary prevention in coronary artery disease: a systematic review and meta-analysis. Scand J Caring Sci. 2020; 34(3): 585–603.
  98. Inglis SC, Clark RA, Dierckx R, et al. Structured telephone support or non-invasive telemonitoring for patients with heart failure. Cochrane Database Syst Rev. 2015; 2015(10): CD007228.
  99. Chauhan U, McAlister FA. Comparison of Mortality and Hospital Readmissions Among Patients Receiving Virtual Ward Transitional Care vs Usual Postdischarge Care: A Systematic Review and Meta-analysis. JAMA Netw Open. 2022; 5(6): e2219113.
  100. Flodgren G, Rachas A, Farmer AJ, et al. Interactive telemedicine: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2015; 2015(9): CD002098.
  101. Bingham JM, Black M, Anderson EJ, et al. Impact of Telehealth Interventions on Medication Adherence for Patients With Type 2 Diabetes, Hypertension, and/or Dyslipidemia: A Systematic Review. Ann Pharmacother. 2021; 55(5): 637–649.
  102. Izeogu C, Kalinowski J, Schoenthaler A. Strategies to Improve Adherence to Anti-Hypertensive Medications: a Narrative Review. Curr Hypertens Rep. 2020; 22(12): 105.
  103. Peacock E, Craig LS, Krousel-Wood M. Electronic health strategies to improve medication adherence in patients with cardiometabolic disease: current status and future directions. Curr Opin Cardiol. 2022; 37(4): 307–316.
  104. Tam HL, Leung LY, Wong EM, et al. Integration of text messaging interventions into hypertension management among older adults: A systematic review and meta-analysis. Worldviews Evid Based Nurs. 2022; 19(1): 16–27.
  105. Sartori AC, Rodrigues Lucena TF, Lopes CT, et al. Educational Intervention Using on Medication Adherence in Hypertension and Diabetes Patients: A Randomized Clinical Trial. Telemed J E Health. 2020; 26(12): 1526–1532.
  106. Roca S, Lozano ML, García J, et al. Validation of a Virtual Assistant for Improving Medication Adherence in Patients with Comorbid Type 2 Diabetes Mellitus and Depressive Disorder. Int J Environ Res Public Health. 2021; 18(22).
  107. He Q, Zhao X, Wang Y, et al. Effectiveness of smartphone application-based self-management interventions in patients with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. J Adv Nurs. 2022; 78(2): 348–362.
  108. Xu H, Long H. The Effect of Smartphone App-Based Interventions for Patients With Hypertension: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth. 2020; 8(10): e21759.
  109. Mikulski BS, Bellei EA, Biduski D, et al. Mobile Health Applications and Medication Adherence of Patients With Hypertension: A Systematic Review and Meta-Analysis. Am J Prev Med. 2022; 62(4): 626–634.
  110. Munshi KD, Amelung K, Carter CS, et al. Impact of a diabetes remote monitoring program on medication adherence. J Manag Care Spec Pharm. 2021; 27(6): 724–731.
  111. Meng WW, Bai YYi, Yan Li, et al. Effect of Home Blood Pressure Telemonitoring Plus Additional Support on Blood Pressure Control: A Randomized Clinical Trial. Biomed Environ Sci. 2023; 36(6): 517–526.
  112. NHS. Shared decision-making. https://www.england.nhs.uk/personalisedcare/shared-decision-making/ (August 12, 2024).