It mainly depends on your skill level however in general, accuracy is all about the finger control, learning how to take advantage of the local offset, and staying consistent with your practice.
Back when I was evaluating players, most players have A LOT of problems with keeping accuracy on low bpm streams but they can accurate other patterns fine. With those people, I tell them to put in more time practicing low bpm long stream maps than you do with other kinds of maps and they always improve if they stick to it.
Now, if you are a player who can get good accuracy on no mod already but you are having problems with getting good accuracy with HR. That means that you have either a reading problem with HR or you haven't practiced higher OD (OD9+) maps enough with no mod. Really the best solution is to just start out with the hard difficulties first with HR mod on and practice that more than you do with anything else. If you can get 98% or higher every time then you should be ready for insane difficulties (4.5-5 star insane difficulties that is, as a starting part for insane) and then you grow from there as long as you stay consistent with it.
Now if you have problems with accuracy in general...that's a whole different story. You will have to first only stick to no mod stuff only (unless if you are a strictly hidden player then just only stick with hidden). Learn how to really read that approach circle and then practice hitting it the moment it touches the corners of the circle. If for some reason, you are not getting 300's from that then that is when you need to adjust your local offset so that every time it touches the edge of the circle, you will always get a 300. Once you got that down, your general accuracy should start improving within a couple weeks or less depending how determined you are. Just remember to play maps that are within your comfort star difficulty zone, make sure to slowly play higher OD maps as your accuracy improves and to NOT play AR10+ maps.
Here's a list of threads that I recommend you read over:
1.
https://osu.ppy.sh/forum/t/187364#_=_ (that includes all the other threads in the post)
2. Bunch of threads:
https://osu.ppy.sh/forum/133 Rohulk's overall accuracy training:
http://ask.fm/Rohulk/answers/130126740315#_=_4. My general accuracy tips:
http://ask.fm/Ripxosu/answers/123959710803 5. Other ask stuff you may find useful if you scroll down:
http://ask.fm/ripxosu/best#_=_
I hope this helps! :)
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