Adhärenz / Compliance – Your cooperation matters!
High blood pressure is usually discovered by chance during a medical exam. People themselves rarely notice it in the early stages. For that reason many find it hard to see the need to change their lifestyle or to take medication. The medical term "compliance", which is now considered somewhat outdated, broadly describes a patient's cooperative behaviour and willingness to actively participate in their treatment. You could also call it therapy adherence. A patient has good compliance if they consistently follow their doctor's advice. Unfortunately, in the area of drug treatment for high blood pressure, only about 50 percent of patients maintain this over time.
Nowadays "compliance" has largely been replaced by "adherence." While compliance used to mean mainly that the patient follows the doctor's instructions, adherence stands for a trusting doctor-patient relationship on equal terms. The idea that the doctor dictates and the patient simply follows is being replaced by a treatment agreement made with the patient as an active partner. Any required lifestyle change, for example, should also be achievable for the patient. The patient's individual needs must be considered alongside the treatment goals. Therefore the plan must be discussed together and, if necessary, implemented in smaller steps that the patient can manage, or adjusted to the patient's possibilities.
In hypertension treatment experts estimate that at least half of prescribed medications are not taken or are taken inadequately. Although reducing high blood pressure is rarely a therapeutic problem, only about 50 percent of people with hypertension achieve normal blood pressure while on therapy this can also be a sign of insufficient cooperation from patients. And this affects at least 150,000 people in Germany each year who die from the consequences of high blood pressure.
So why is cooperation often lacking?
As described above, high blood pressure often causes no symptoms. For most people there is therefore no immediate pressure to remove an unwanted or potentially painful condition. Many are unsettled by the side effects listed in the medication leaflet and see that as a welcome reason not to take the tablets. For others, refusing to cooperate is a way of asserting their autonomy against medical advice or prescriptions they perceive as authoritarian.
This is where the adherence concept also comes in, bringing the patient on board as an active partner. Good health literacy also strengthens adherence. If you know your condition and engage with it and understand it as well as possible, you can act with much more confidence in discussions with your doctor as an equal partner. You can improve your health literacy about high blood pressure, among other things, by reading our BloodPressureDB Infomails.
However, even the best therapy, the best advice on lifestyle changes, or the most well-designed diet plan does no good if it is not followed.
I'd like to draw a comparison:
For most people, brushing their teeth morning and night is simply part of the daily routine. You know that teeth will be damaged if you don't brush them, even if you don't feel any pain. Pain only comes once the teeth are already damaged.
High blood pressure behaves very similarly. At first it causes no symptoms. Nevertheless or precisely because of that it is important to follow your doctor's recommendations and take prescribed medications regularly and as directed to prevent further health problems.
Make this part of your daily routine. Take your tablets after breakfast or dinner (depending on what you and your doctor have agreed), go for a half-hour walk at a set time, and add more healthy dishes to your menu. The more often you make these changes, the more they become a habit and the easier they get, until you no longer have to think about them. If unwanted side effects occur which can happen especially at the start of medication discuss them with your doctor instead of quietly stopping the tablets or reducing the dose.
The doctor cannot repair you like a car. But they can work with you to develop a plan to lower your blood pressure in a way that suits you. The responsibility for daily implementation then lies with you. This means taking personal responsibility for your own health.
Sources:
This article comes from BloodPressureDB – the leading app since 2011 that helps hundreds of thousands monitor their blood pressure every day.
Our content is based on carefully researched, evidence-based data and is continuously updated (as of 11/2024).
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
