Factors associated with lost to follow-up (LTFU) among patients with hypertension: A scoping review

Regular follow-up appointments are essential for effective hypertension management; however, many patients fail to attend scheduled visits and become lost to follow-up (LTFU). Understanding the factors associated with LTFU is important for preventing hypertension-related complications such as stroke, cardiovascular disease, and kidney disorders. This scoping review aimed to identify factors associated with LTFU among patients with hypertension and to summarize the terminology and timeframes used to define LTFU in the literature. A scoping review was conducted following PRISMA-ScR guidelines. A systematic search was performed for studies published between 2010 and 2025 across MEDLINE, Scopus, Ovid MEDLINE, Web of Science, Google Scholar, and grey literature sources. The review protocol was registered with the Open Science Framework (OSF) (Registration: https://osf.io/a2wsg/). The methodological quality of included studies was assessed using design-specific tools. A total of 4,039 records were identified, and after removing duplicates, 2,956 articles were screened. Thirteen studies met the inclusion criteria, including six cross-sectional studies, four mixed-methods studies, one qualitative study, one retrospective case-control study, and one cohort study. Nine studies were rated as high quality and four as moderate quality. The definitions and terminology used to characterize LTFU varied considerably across studies. Factors associated with LTFU were grouped into five categories: patient-related, treatment and disease-related, healthcare provider-related, health service and system-related, and interpersonal factors. Patient-related factors were most frequently reported, followed by treatment and disease characteristics, while healthcare provider, service, and system-related factors were less commonly described. Interpersonal factors were reported in only three studies. This scoping review identified a range of patient-, treatment-, healthcare provider-, and health system-related factors contributing to LTFU among patients with hypertension. The findings highlight the complexity of LTFU in hypertension care and underscore the need for targeted strategies to strengthen follow-up mechanisms, improve patient engagement, and enhance continuity of care.