Hypertension

Uncontrolled BP can reflect cost, access, communication, and competing needs. Identify the barrier before labeling a patient nonadherent; pair the treatment decision with a practical response.

• Make monitoring accessible: Arrange a validated device and suitable cuff through coverage or a loan program. Confirm technique by demonstration; accept the AHA Blood Pressure Log or telephone reporting when digital access is limited.
• Make treatment sustainable: Ask about cost, refill access, transport, and work schedules. Use affordable once-daily regimens or single-pill combinations when covered; coordinate refills and delivery where available.
• Support understanding and follow-up: Use qualified interpreters and teach-back. Agree on how readings will reach the team, who will respond, and when BP and safety labs will be reviewed; offer flexible visit formats.
• Extend the care team: Use nurse/pharmacist titration protocols and community health workers for navigation, food-access referrals, and follow-up. Centers for Disease Control and Prevention (CDC) Team-Based Care guidance supports implementation.
• Measure where care falls short: Track control, intensification, missed follow-up, and device access by race/ethnicity, language, insurance, or geography when data permit. Use gaps to target resources and reassess results.