Physicians’ opinion on medication adherence of hypertensive patients: data from an Nationwide Russian Survey

Aim. To survey Russian medical professionals on compliance issues, since high adherence to antihypertensive therapy (AHT) is one of the main conditions for satisfactory control of hypertension (HTN) and reduction of cardiovascular risk. A physician plays a key role in increasing adherence, but in Russia there is insufficient data on how specialists perceive and solve the problem of low compliance.

Material and methods. Between March 4 and June 1, 2025, an anonymous online survey was conducted via the website of the Russian Society of Cardiology. The questionnaire included 11 items in different formats and was completed on a voluntary basis.

Results. A total of 344 physicians participated, mostly women (78%), cardiologists (83%), with over 10 years of experience (74%), and involved in outpatient care (86%). The average time spent discussing AHT with patients was 1-5 minutes (28%) or 6-10 minutes (38%). Most respondents (73%) believed that only 0-15% of their patients with HTN never initiate the recommended therapy, and 33% estimated that more than half continue treatment one year after initiation. A total of 41,5% of physicians agreed that nonadherence is usually a conscious decision, while most considered adherence improvement possible but doubted the existence of a universal strategy (62,2%). Unstructured patient interviews were the most common method for assessing adherence, while fewer than 25% used direct methods. Physicians primarily rely on patient education and treatment simplification to improve adherence. Shared decision-making and educational programs were less frequently used. Major barriers identified included high workload, limited consultation time, and lack of systemic support.

Conclusion. Surveyed physicians perceive low adherence in patients with HTN as a complex and multifaceted construct, but are optimistic about the potential for its improvement. The current level of implementation of modern methods for assessing and improving adherence remains low, partly due to high workload. There is a need to develop simple, easy-to-implement algorithms for identifying and addressing nonadherence, as well as to optimize the organizational conditions of outpatient care in order to provide effective support for patients with HTN.

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