A Systematic Review of the Hill-Bone Compliance to Blood Pressure Therapy Scale

Abstract

Background Poor medication adherence hampers hypertension control and increases the risk of adverse health outcomes. Medication adherence can be measured with direct and indirect methods. The Hill-Bone Compliance to High Blood Pressure Therapy (HBCHBPT) Scale, one of the most popular adherence measures, indirectly assesses adherence to hypertension therapy in three behavioral domains: appointment keeping, diet and medication adherence. Aim To synthesize evidence on the use of the HBCHBPT Scale, including psychometric properties, utility in diverse patient populations, and directions for future clinical use and research. Methods We searched electronic databases, specifically CINAHL, PubMed, PsychInfo, Embase, and Web of Science. We included original studies that used the HBCHBPT Scale or its subscales to measure a health outcome, or methodological studies involving translations and validations of the scale. We extracted and synthesized data following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Results Fifty studies were included in this review, 44 on hypertension, two on diabetes, and others on other chronic conditions. The scale was successfully translated into numerous languages and used in descriptive and intervention studies. The scale demonstrated sound psychometric properties (Cronbach’s α coefficient 0.75) and sensitivity to capture intervention effects when used to evaluate the effectiveness of high blood pressure adherence interventions. The medication-taking subscale of HBCHBPT performs best and is widely used in diverse contexts to assess medication adherence for chronic conditions. Conclusion The HBCHBPT Scale has high versatility globally and has been used in various settings by various healthcare worker cadres and researchers. The scale has several strengths, including high adherence phenotyping capabilities, contributing to the paradigm shift toward personalized health care.

Arabic translation and cultural adaptation of Hill-Bone compliance to high blood pressure therapy scale

“…The 14-item Hill-Bone CHBPT scale has been validated in various clinical settings and cultures and is considered a reliable indirect method for the assessment of medication adherence in patients with HTN. It has been translated into over 25 different languages and is widely utilized due to its ease of use, accessibility, high predictive validity, and high clinical utility for patient-specific treatment management ( Commodore-Mensah, Delva et al, 2023 ). Although two published studies have administered the Hill-Bone CHBPT scale in Arabic language, the need for a reliable and validated version in the Arabic language still remained ( Alsolami et al, 2013 , Al-Daken and Eshah, 2017 ).…”

“…The internal consistency of the original version was based upon two independent patient groups with HTN. The Cronbach’s alpha was reported to be 0.74 and 0.84, and subsequent validation studies have ranged from 0.62 to 0.88( Kim et al, 2000 , Commodore-Mensah et al, 2023 ). In this study, the factor analysis extracted three factors which represented the three subscales: factor 1: medication taking (items 1, 2, and 8–14), factor 2: reducing sodium intake (items 3–5), and factor 3: appointment keeping (items 6 and 7).…”

Factors Affecting the Level of Adherence to Hypertension Medications: A Cross-Sectional Study Using the Hill-Bone Questionnaire

“…This scale evaluates adherence in three behavioral domains: appointment-keeping, diet, and medication adherence. 12 …”

“…This scale evaluates adherence in three behavioral domains: appointment-keeping, diet, and medication adherence. 12 While numerous studies have explored factors influencing medication adherence in hypertensive patients, few have focused on low-and middle-income countries, with none conducted in Jordan. Therefore, this study aims to be the first to evaluate the level of adherence to antihypertensive medications among patients in Jordan.…”