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Hypertension - Concordance

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Hypertension – Concordance

Medication is an important aspect of health care and the drugs budget for the NHS is more than £10.7 billion a year. Unfortunately between 33 and 50% of people with long term conditions do not use their medication as prescribed. This means that apart from the patient not getting the benefit from the medication, wastage is costing the health service more than £100 million pounds annually.

Many factors affect medication concordance and these involve both the health professional and the patient. It should never be thought to be solely a patient issue. Often there has been a failure to establish agreement between the clinician and the patient that they will take the medication in the first place, and subsequently there may be a lack of follow up and support. To understand a patient’s non adherence to medication we need to establish good open communication with them, consider their perspectives and encourage open discussion related to any concerns and understanding they may have.

This resource, consisting of five assessment questions at advanced level, tests your understanding of the principles of concordance, and the reasons for non-adherence to treatment for hypertension. Complete the resource, including reading the featured articles and undertaking some or all of the activities, to obtain a certificate for one hour of continuing professional development to include in your annual portfolio.

Aims and Objectives

On completion of this resource you should have an understanding of:

  • The reasons why people are not concordant with prescribed medication
  • How you can increase patient involvement with decisions about medication
  • The need for appropriate information in relation to drug therapy
  • The importance and benefits of a comprehensive medication review
  • The ways you can support patients to help them take their medication more effectively

Practice Nurse featured articles

Hypertension for the practice nurse Dr Mary Lowth

Shared decision-making: what’s new, and why is it so important? Liz Bryant

Medicolegal issues: Gaining consent Diane Baylis, Medical Protection Society

Recommended reading

NICE CG 76. Medicines adherence, 2009

NICE PH 6, Behaviour change: the principles for effective intervention, 2007 (including 2011 update)

NICE CG 127. Hypertension: Clinical management of primary hypertension in adults, 2011,

Davies M et al, for UK National screening Committee. The updated handbook for vascular risk assessment, risk reduction and risk management, 2012

Bane C, Hughes C, Cupples M, McElnay J. The journey to concordance for patients with hypertension: a qualitative study in primary care. 2007. Pharmacy World & Science 2007;29:534-540.

Education for Health courses and workshops

CVD risk e-learning diploma

Hypertensive diploma

Coronary Heart Disease distance learning diploma

Hypertension – workshop

Putting Prevention First – workshop

Tackling CVD risk – workshop

Self-Management Support and Health Behaviour Change – workshop

Stroke – workshop