Behaviors critical to hypertensive patients' achieving therapeutic control and assuming active responsibility for their own care were defined by an interdisciplinary group brought together by the National High Blood Pressure Education Program. The report focused on the achievement and maintenance of long-term control through drug therapy and concentrated on the patient-physician interaction as a critical factor. The basic hypothesis that active participation by the patient favors successful management of hypertension identifies the physician, the prime diagnostician and initiator of the subsequent interaction, as the promoter of that important collaboration. The working group views the patient as the decision-maker and problemsolver, with the professional functioning as advisor and guide. This synthesis of available theory and practice in therapy adherence includes knowledge, attitudes, and skills defined under four major behaviors: making the decision for control, taking medication, monitoring progress, and problem solving.
(JAMA 241:2534-2537, 1979)