Community Pharmacy Interventions for Improving Adherence in Chronic Hypertension

Abstract

Hypertension is the leading modifiable driver of global cardiovascular mortality, yet fewer than one in four affected adults worldwide have their blood pressure adequately controlled, a gap sustained in large part by poor long-term medication adherence rather than a shortage of effective drugs. Community pharmacies occupy an unusually well-placed position to close this gap: pharmacists see chronic hypertensive patients far more often than prescribing physicians do, hold relevant pharmacological and counseling expertise, and require no appointment to access. This article synthesizes the literature on community pharmacy interventions for hypertension adherence and control, tracing the evidence from foundational meta-analyses of pharmacist-delivered care, through specific behavioral, educational, and packaging interventions, to the newer wave of remote monitoring, telehealth, and digital adherence tools, and the collaborative-practice arrangements that determine whether a pharmacist's clinical judgment can translate into an actual prescribing change. We give particular weight to the consistency of effect across independent meta-analyses spanning a decade, to cost-effectiveness evidence supporting expanded pharmacist scope of practice, and to the geographic mismatch between where this evidence has been generated and where the burden of uncontrolled hypertension is now growing fastest. Read together, the evidence supports community pharmacy involvement as a coherent, well-evidenced, and underused component of chronic hypertension management, while leaving component isolation, long-term durability beyond typical trial follow-up, and translation to low- and middle-income settings as an open research and implementation agenda.