Correlates of Medication Nonadherence Among Latinos With Type 2 Diabetes

Parada, Humberto; Horton, Lucy A.; Cherrington, Andrea; Ibarra, Leticia; Ayala, Guadalupe X.

doi:10.1177/0145721712445215

Cited by 35 publications

(42 citation statements)

References 32 publications

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“…However, our findings are validated by other adherence studies that have documented similar rates and have highlighted known socioeconomic disparities in adherence. 40,41 Further research should seek to generalize the effectiveness of the PCL among a more diverse study sample from an array of ambulatory care and pharmacy practices, not limited solely to settings serving those that are socioeconomically disadvantaged.…”

Section: Limitationsmentioning

confidence: 99%

A Patient-Centered Prescription Drug Label to Promote Appropriate Medication Use and Adherence

et al. 2016

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BACKGROUND: Patient misunderstanding of prescription drug label instructions is a common cause of unintentional misuse of medication and adverse health outcomes. Those with limited literacy and English proficiency are at greater risk. OBJECTIVE: To test the effectiveness of a patientcentered drug label strategy, including a Universal Medication Schedule (UMS), to improve proper regimen use and adherence compared to a current standard. DESIGN: Two-arm, multi-site patient-randomized pragmatic trial. PARTICIPANTS: English-and Spanish-speaking patients from eight community health centers in northern Virginia who received prescriptions from a central-fill pharmacy and who were 1) ≥30 years of age, 2) diagnosed with type 2 diabetes and/or hypertension, and 3) taking ≥2 oral medications. INTERVENTION: A patient-centered label (PCL) strategy that incorporated evidence-based practices for format and content, including prioritized information, larger font size, and increased white space. Most notably, instructions were conveyed with the UMS, which uses standard intervals for expressing when to take medicine (morning, noon, evening, bedtime). MAIN MEASURES: Demonstrated proper use of a multidrug regimen; medication adherence measured by selfreport and pill count at 3 and 9 months. KEY RESULTS: A total of 845 patients participated in the study (85.6 % cooperation rate). Patients receiving the PCL demonstrated slightly better proper use of their drug regimens at first exposure (76.9 % vs. 70.1 %, p = 0.06) and at 9 months (85.9 % vs. 77.4 %, p = 0.03). The effect of the PCL was significant for English-speaking patients (OR 2.21, 95 % CI 1.13-4.31) but not for Spanish speakers (OR 1.19, 95 % CI 0.63-2.24). Overall, the intervention did not improve medication adherence. However, significant benefits from the PCL were found among patients with limited literacy (OR 5.08,) and for those with medications to be taken ≥2 times a day (OR 2.77, 95 % CI 1.17-6.53). CONCLUSIONS:A simple modification to pharmacygenerated labeling, with minimal investment required, can offer modest improvements to regimen use and adherence, mostly among patients with limited literacy and more complex regimens. Trial Registration (ClinicalTrials.gov): NCT00973180, NCT01200849

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Section: Limitationsmentioning

confidence: 99%

A Patient-Centered Prescription Drug Label to Promote Appropriate Medication Use and Adherence

et al. 2016

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“…As reported in the literature, Hispanic/Latinos have a 60% rate of non-compliance to medical treatment plans; this is further complicated by the presence of depressive symptoms (Parada, et al, 2012). This shows the importance of building a strong and culturally sensitive program where DCS serve as pivotal providers to address issues of poor compliance, lack of trust or other psychosocial aspects that interfere with the patient's ability to comply with recommended medical and psychiatric treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Smoking (Y/N) and diagnosis of diabetes (Y/N) verified by medical record were collected since these are frequent comorbidities observed in depressed patients attending community clinics (Parada, et al, 2012; Patton et al, 1998). No additional biological or behavioral data was analyzed.…”

Section: Methodsmentioning

confidence: 99%

“…It is known that depressive symptoms such as poor concentration, anhedonia, poor motivation, lack of energy affect the ability of an individual to care for chronic medical conditions (Gilmer TP, et al, 2008). For example, in a recent cross-sectional study, Parada and colleagues (2012) found that high levels of depression among Hispanic/Latinos were significantly correlated with poor adherence to medication and treatment for diabetes (Parada, Horton, Cherrington, Ibarra, & Ayala, 2012). …”

Section: Introductionmentioning

confidence: 99%

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Improvement in Depressive Symptoms Among Hispanic/Latinos Receiving a Culturally Tailored IMPACT and Problem-Solving Intervention in a Community Health Center

Camacho

González

Castañeda

et al. 2014

Community Ment Health J

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The present study investigated whether a culturally-tailored problem-solving intervention delivered by a trained depression care specialist (DCS) would improve depressive symptoms over a six month period among Hispanic/Latino patients in a federally-qualified community health center by the California-Mexico border. Participants included 189 low income Hispanic/Latino patients of Mexican heritage. Based on the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) evidence-based treatment, patients received evidence-based problem-solving therapy. The Patient Health Questionnaire-9 (PHQ-9) was administered to assess changes in self-reported depressive symptoms between baseline and monthly for a 6-month follow up period. The majority of participants were female (72.5%) with a mean age of 52.5 (SD=11.7). The mean PHQ-9 at baseline was 16.9 (SD=4.0) and at the 6-month follow-up, the average PHQ-9 decreased to 9.9 (SD=5.7). A linear mixed model analysis showed significant improvement in PHQ-9 scores over a 6 month period (F=124.1; p<0.001) after controlling for age, gender, smoking and diabetes. There was a significant three way interaction between time, gender and smoking (p=0.01) showing that the depressive symptoms among male smokers did not improve as much as non-smoking males and females. Results suggest that a culturally-tailored problem solving approach can significantly reduce depressive symptoms among Hispanic/Latino low-income patients.

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“…In 2013, CDSDP served 52,511 patients, including 37% who were under 18 years of age. 29,30 For CA-CORD, CDSDP leads the HC intervention. ICPHD monitors local health problems, needs and resources, policy development, and leadership that foster local involvement and equitable distribution of resources.…”

Section: Partnershipsmentioning

confidence: 99%

Our Choice/Nuestra Opción:The Imperial County, California, Childhood Obesity Research Demonstration Study (CA-CORD)

et al. 2015

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Background: Despite recent declines among young children, obesity remains a public health burden in the United States, including among Latino/Hispanic children. The determining factors are many and are too complex to fully address with interventions that focus on single factors, such as parenting behaviors or school policies. In this article, we describe a multisector, multilevel intervention to prevent and control childhood obesity in predominantly Mexican-origin communities in Southern California, one of three sites of the CDC-funded Childhood Obesity Research Demonstration (CA-CORD) study.Methods: CA-CORD is a partnership between a university-affiliated research institute, a federally qualified health center, and a county public health department. We used formative research, advisory committee members' recommendations, and previous research to inform the development of the CA-CORD project. Our theory-informed multisector, multilevel intervention targets improvements in four health behaviors: fruit, vegetable, and water consumption; physical activity; and quality sleep. Intervention partners include 1200 families, a federally qualified health center (including three clinics), 26 early care and education centers, two elementary school districts (and 20 elementary schools), three community recreation centers, and three restaurants. Intervention components in these sectors target changes in behaviors, policies, systems, and the social and physical environment. Evaluation activities include assessment of the primary outcome, BMI z-score, at baseline, 12-, and 18-months post-baseline, and sector evaluations at baseline, 12, and 24 months.Conclusions: Identifying feasible and effective strategies to prevent and control childhood obesity has the potential to effect real changes in children's current and future health status.

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Correlates of Medication Nonadherence Among Latinos With Type 2 Diabetes

Cited by 35 publications

References 32 publications

A Patient-Centered Prescription Drug Label to Promote Appropriate Medication Use and Adherence

A Patient-Centered Prescription Drug Label to Promote Appropriate Medication Use and Adherence

Improvement in Depressive Symptoms Among Hispanic/Latinos Receiving a Culturally Tailored IMPACT and Problem-Solving Intervention in a Community Health Center

Our Choice/Nuestra Opción:The Imperial County, California, Childhood Obesity Research Demonstration Study (CA-CORD)

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