Frontiers in Medicine · Nov 3, 2026
Efficacy of tailored interventions aimed at improving adherence to blood pressure lowering interventions: findings from a systematic review and meta-analysis
By Alessandro Croce, Martina Vigore, Martino Francesco Pengo et al.
Background: Adherence to blood pressure-lowering interventions is crucial for effective hypertension management, yet poor adherence remains a major challenge. Methods: This systematic review and meta-analysis evaluates the efficacy of tailored interventions (TIs) in improving adherence to both pharmacological and lifestyle-based treatments. A comprehensive search of six databases identified 25 eligible randomized controlled trials, of which 16 provided quantitative data for meta-analysis. Blood pressure reduction served as an objective clinical outcome potentially influenced by adherence, while self-reported adherence was assessed via standardized questionnaires. Results: The meta-analysis found that TIs led to a modest but significant reduction in systolic blood pressure (-2.20 [-3.84; -0.57] mmHg) compared to usual care (with a moderate level of certainty). The effect was more pronounced in studies with shorter follow-up durations (≤6 months). Conversely, no significant improvements were observed in self-reported adherence measures. Most interventions were multicomponent, involving digital tools, counseling, and behavioral strategies, often delivered by pharmacists and nurses in outpatient settings. Despite their potential, the effectiveness of TIs varied based on study design, intervention type, and patient characteristics. Conclusions: TIs may contribute to improved blood pressure control in hypertensive patients. The findings indicate the need for more standardized adherence assessment tools and for strategies to sustain behavioral changes in the long-term. Future research should refine intervention models and explore cost-effectiveness of personalized approaches to improving adherence in hypertensive patients.