Improving Medication Routines and Adherence in Hypertensive African Americans: Finding the Needle in the Haystack

Kountz, David S.; Kofman, E

doi:10.1111/jch.12564

Cited by 3 publications

(8 citation statements)

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“…These findings are unique, considering the relationship of low SES as a well‐established predictor of suboptimal adherent behaviors and poor health outcomes . These findings underlie the premise that low SES is not an automatic predictor of poor medication adherence or poor health outcomes, further revealing the complex and interrelated factors underlying medication adherence and other important self‐management behaviors.…”

Section: Introductionmentioning

confidence: 81%

“…Non‐adherence to BP medication is considered a major contributor of uncontrolled HTN in young adult black women . Reported barriers contributing to non‐adherence in this age group have ranged from both isolated and multidimensional factors deriving from patient, health system, therapy, condition, and social/economic categories .…”

Section: Introductionmentioning

confidence: 99%

“…Identification and examination of the barriers to BP medication adherence in black people have been instrumental in illuminating factors that contribute to poor HTN control. Conversely, factors enhancing BP medication adherence, particularly in young and early middle‐aged adult black women, are understudied . This is an important observation given that black people in general tend to develop HTN at earlier ages, are more resistant to treatment, face unique life stressors, less likely to be adherent, and face greater morbidity and mortality .…”

Section: Introductionmentioning

confidence: 99%

“…Conversely, factors enhancing BP medication adherence, particularly in young and early middle‐aged adult black women, are understudied . This is an important observation given that black people in general tend to develop HTN at earlier ages, are more resistant to treatment, face unique life stressors, less likely to be adherent, and face greater morbidity and mortality . What remains unclear is the knowledge of which factors facilitate positive BP medication adherence in spite of adverse social determinants for some women.…”

Section: Introductionmentioning

confidence: 99%

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The associations among illness perceptions, resilient coping, and medication adherence in young adult hypertensive black women

Spikes

Higgins

Lewis

et al. 2019

J of Clinical Hypertension

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Hypertension, a modifiable risk factor of cardiovascular disease, is largely responsible for the disproportionate morbidity and mortality in black women. Black women 20 years of age and older have a higher prevalence of HTN compared to white women (44% vs 28%). Poor adherence and non‐adherence to hypertensive medications have been strongly indicated as a primary contributor to the early onset of disparity in cardiovascular disease morbidity and mortality experienced by black people. The purpose of this study was to examine medication adherence in black women relative to sociodemographic, clinical, cultural context, psychosocial, cognitive, and behavioral factors. This was a prospective, descriptive cross‐sectional study of N = 85, hypertensive black women, with mean age of 39 ± 5.4 years, 18‐45 years of age. Variables and measures included: sociodemographic characteristics, clinical, adverse social stressors, psychosocial, cognitive‐behavioral factors, and medication adherence. Descriptive statistics, correlations, multivariate logistic regressions, and moderation analysis were tested. 81.2% (n = 69) of the sample was categorized as non‐adherent. SBP was the only clinical covariate associated with HTN medication adherence. HTN illness perceptions, composite score, resilient coping, depressive symptoms, exposure to lifetime gender, and racial stressors, were not associated with HTN medication adherence. Using multivariate logistic regression, decreased SBP and lower scores on the “Consequence” dimension of the HTN illness perception scale were associated with medication adherence (χ2 = 10.53, P = .001). Adherence was associated with both the “Consequence” and “Identity” dimensions of the HTN illness perception scale indicating the need and importance for clinicians to have open and honest communication regarding HTN and its treatment in facilitating adherence.

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Section: Introductionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The associations among illness perceptions, resilient coping, and medication adherence in young adult hypertensive black women

Spikes

Higgins

Lewis

et al. 2019

J of Clinical Hypertension

View full text Add to dashboard Cite

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“…67 The prevalence of hypertension, heart failure, and stroke is highest among blacks, with CVD initially occurring at younger ages and being more resistant to treatment. 50,68,69 For example, 47% of blacks were estimated to have hypertension in 2015 compared with 40% of white non-Hispanics, consequently increasing their risk for stroke and heart failure. 1,[70][71][72] Studies of traumatic spinal cord injury and other chronic conditions suggest that blacks were more likely to receive informal care from other family members, friends, church support, and others, whereas whites were more likely to receive informal or family care from spouses.…”

Section: Special Concerns By Age Sex and Race/ Ethnicitymentioning

confidence: 99%

Projected Costs of Informal Caregiving for Cardiovascular Disease: 2015 to 2035: A Policy Statement From the American Heart Association

Dunbar¹,

Khavjou²,

Bakas³

et al. 2018

Circulation

198

102

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INTRODUCTION:In a recent report, the American Heart Association estimated that medical costs and productivity losses of cardiovascular disease (CVD) are expected to grow from $555 billion in 2015 to $1.1 trillion in 2035. Although the burden is significant, the estimate does not include the costs of family, informal, or unpaid caregiving provided to patients with CVD. In this analysis, we estimated projections of costs of informal caregiving attributable to CVD for 2015 to 2035. METHODS:We used data from the 2014 Health and Retirement Survey to estimate hours of informal caregiving for individuals with CVD by age/sex/race using a zero-inflated binomial model and controlling for sociodemographic factors and health conditions. Costs of informal caregiving were estimated separately for hypertension, coronary heart disease, heart failure, stroke, and other heart disease. We analyzed data from a nationally representative sample of 16 731 noninstitutionalized adults ≥54 years of age. The value of caregiving hours was monetized by the use of home health aide workers' wages. The per-person costs were multiplied by census population counts to estimate nation-level costs and to be consistent with other American Heart Association analyses of burden of CVD, and the costs were projected from 2015 through 2035, assuming that within each age/sex/racial group, CVD prevalence and caregiving hours remain constant. RESULTS:The costs of informal caregiving for patients with CVD were estimated to be $61 billion in 2015 and are projected to increase to $128 billion in 2035. Costs of informal caregiving of patients with stroke constitute more than half of the total costs of CVD informal caregiving ($31 billion in 2015 and $66 billion in 2035). By age, costs are the highest among those 65 to 79 years of age in 2015 but are expected to be surpassed by costs among those ≥80 years of age by 2035. Costs of informal caregiving for patients with CVD represent an additional 11% of medical and productivity costs attributable to CVD. CONCLUSIONS:The burden of informal caregiving for patients with CVD is significant; accounting for these costs increases total CVD costs to $616 billion in 2015 and $1.2 trillion in 2035. These estimates have important research and policy implications, and they may be used to guide policy development to reduce the burden of CVD on patients and their caregivers.

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The Relationship Among Health Beliefs, Depressive Symptoms, Medication Adherence, and Social Support in African Americans With Hypertension

et al. 2019

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Background: African Americans are disproportionately affected by hypertension and have lower medication adherence when compared to other racial groups. Antecedent factors such as beliefs surrounding hypertension, the presence or absence of social support, and depressive symptoms have not been extensively studied collectively in relation to hypertension medication adherence in African Americans. Objective: To determine the associations among demographic and clinical factors, depressive symptoms, hypertension beliefs, and social support with blood pressure medication adherence in middle-aged African American adults with a diagnosis of hypertension. Methods: A cross-sectional study of (N = 120) African Americans (mean age, 49 years; 22.5% men) with a current diagnosis of metabolic syndrome, including hypertension, who reported having and taking a prescribed blood pressure–lowering medication were included. Descriptive statistics, bivariate correlation analysis, and logistic regression using odds ratio were used to examine the effects of high blood pressure beliefs, social support, and depression on medication adherence. Results: A small but significant relationship was found between medication adherence and number of comorbidities (r = 0.19, P = .04). In a multivariate regression model, after controlling for gender, comorbidities remained associated with medication adherence (β = 0. 77, P = .04). Depressive symptoms, high blood pressure beliefs, and social support did not have a significant relationship with medication adherence. Conclusions: Multiple comorbidities may have a positive impact upon medication adherence. Further study is needed in a larger sample of African Americans who have a diagnosis of hypertension in addition to other comorbidities requiring medication management.

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Improving Medication Routines and Adherence in Hypertensive African Americans: Finding the Needle in the Haystack

Cited by 3 publications

References 12 publications

The associations among illness perceptions, resilient coping, and medication adherence in young adult hypertensive black women

The associations among illness perceptions, resilient coping, and medication adherence in young adult hypertensive black women

Projected Costs of Informal Caregiving for Cardiovascular Disease: 2015 to 2035: A Policy Statement From the American Heart Association

The Relationship Among Health Beliefs, Depressive Symptoms, Medication Adherence, and Social Support in African Americans With Hypertension

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