Patient-Reported Medication Adherence Barriers Among Patients with Cardiovascular Risk Factors

Zullig, Leah L.; Stechuchak, Karen M.; Goldstein, Kenneth M.; Olsen, Maren K.; McCant, Felicia; Danus, Susanne; Crowley, Matthew J; Oddone, Eugene Z.; Bosworth, Hayden B.

doi:10.18553/jmcp.2015.21.6.479

Cited by 28 publications

(36 citation statements)

References 30 publications

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“…National studies of CVD prevention find that lack of support directly contributes to an inability to engage in prevention-related behavior (31) . Similarly, previous analyses from this study cohort found that lacking someone to assist tracking medications is associated with higher medication barriers (45) . For men, being married or cohabiting appears to be an important factor in lowering CVD risk (59) .…”

Section: Discussionsupporting

confidence: 72%

“…Weight, height, and blood pressure were also measured at the baseline visit. Participants were also asked to complete the Rapid Estimate of Adult Literacy in Medicine (REALM) test (45) . We dichotomized the REALM scores into a binary measure identifying low literacy (equivalent to an eighth grade reading level) using a total score <60 as has been done previously (45) .…”

Section: Methodsmentioning

confidence: 99%

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Impact of Gender on Satisfaction and Confidence in Cholesterol Control Among Veterans at Risk for Cardiovascular Disease

Goldstein¹,

Stechuchak²,

Zullig

et al. 2017

Journal of Women's Health

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Background Compared to men, women have poorer lipid control. While potential causes of this disparity have been explored, it is unknown whether patient-centered factors such as satisfaction and confidence contribute. We evaluated: 1) if satisfaction with lipid control and confidence in ability to improve it vary by gender; and 2) whether socio-demographic characteristics modify the association. Methods We evaluated baseline survey responses from the Cardiovascular Intervention Improvement Telemedicine Study, including self-rated satisfaction with cholesterol levels and confidence in controlling cholesterol. Participants had poorly controlled hypertension and/or hypercholesterolemia. Results 428 Veterans (15% women) participated. Compared with men, women had higher LDL values at 141.2 mg/dL vs. 121.7 mg/dL respectively (p<0.05), higher health literacy, and were less likely to have someone to help track their medications (all p<0.05). In an adjusted model, women were less satisfied with their cholesterol levels than men with estimated mean scores of 4.3 versus 5.6 on a 1–10 Likert scale (p<0.05). There was no significant difference in confidence by gender. Participants with support for tracking medications reported higher confidence levels than those without, estimated mean 7.8 vs. 7.2 (p<0.05). Conclusions Women veterans at high risk for cardiovascular disease were less satisfied with their lipid control than men; however, confidence in ability to improve lipid levels was similar. Veterans without someone to help to track medications were less confident, and women were less likely to have this type of social support. Lack of social support for medication tracking may be a factor in lingering gender-based disparities in hyperlipidemia.

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Section: Discussionsupporting

confidence: 72%

Section: Methodsmentioning

confidence: 99%

Impact of Gender on Satisfaction and Confidence in Cholesterol Control Among Veterans at Risk for Cardiovascular Disease

Goldstein¹,

Stechuchak²,

Zullig

et al. 2017

Journal of Women's Health

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“…These eight trials started recruitment between 2011 and 2014. Of these trials, one included dyads of patients and caregivers (Van Houtven et al, 2014), four targeted cardiovascular disease risk factors including obesity and hypertension (Jackson et al, 2016;Oddone et al, 2017;Voils et al, 2014;Voils et al, 2016;Zullig et al, 2014;Zullig et al, 2015), one addressed smoking cessation (Wilson et al, 2016), one addressed emergency department follow-up (Hastings et al, 2014), and one addressed osteoarthritis of the knee and hip (Allen et al, 2012; Table 1). The mean participant age was 57.7 years for women and 65.9 years for men.…”

Section: Resultsmentioning

confidence: 99%

Enrollment and Retention of Men and Women in Health Services Research and Development Trials

Goldstein

Duan-Porter

Alkon

et al. 2019

Women's Health Issues

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Introduction: Sex-and gender-specific science is essential to inform patient-centered, evidence-based care. Developing such evidence requires adequate inclusion of both women and men in trials. We sought to describe study participation of women and men in Department of Veterans Affairs Health Services Research and Development trials. Methods: We identified recent health services research trials from one Health Services Research and Development Center of Innovation and compared the participation of women and men from trial recruitment to study completion. We also calculated the participation to prevalence ratio (PPR) by sex for each trial. Results: We included eight trials that started recruitment between 2011 and 2014. Only one study purposefully attempted to boost the recruitment of women. Overall, the PPR for women ranged from 0.2 to 4.5, with seven studies having a PPR of greater than 1, indicating that women participated in these trials at proportions greater than their prevalence in the disease population within the Department of Veterans Affairs. The PPR for men ranged from 0.8 to 1.1. Retention was best with those studies that used administrative data for final outcomes assessment. No studies provided results stratified by sex or conducted analyses to explore treatment effect by sex. Conclusions: At a single site, women participated in Health Services Research and Development trials at similar or greater rates to men without cross-study efforts to enrich the recruitment or retention of women. Adding strategic recruitment approaches could further boost the proportion of women in Department of Veterans Affairs trials and enable adequately powered sex-based analyses. Published by Elsevier Inc. on behalf of Jacobs Institute of Women's Health. Sex-and gender-based differences in the pathophysiology, quality of care, and patient experiences of disease require sexand gender-specific science to inform the provision of patientcentered, evidence-based care. For example, when compared with men, women with coronary artery disease are less likely to take statins and antiplatelet medications (Johansen, Hefner, & Foraker, 2015), and respond differently to pharmacologic interventions for pain (Bartley & Fillingim, 2013). Acquiring the evidence needed to optimize patient-centered care for women Supported by the Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) (CIN 13-410

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“…Furthermore, those who were not employed increased risk 1.32, or did not have someone to help with tasks increased risk 1.66 for nonadherence in patients with cardiovascular risk factors. [13] There are defined living in a village compared with a city, dissatisfaction with treatment, forgetfulness, fear of getting used to the medication, adverse effects are associated with lower medication adherence. Evaluating health status as very good, good, or poor compared with excellent also was found associated with lower adherence.…”

Section: Discussionmentioning

confidence: 99%

Are blood pressure values compatible with medication adherence in hypertensive patients?

et al. 2016

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Patient-Reported Medication Adherence Barriers Among Patients with Cardiovascular Risk Factors

Cited by 28 publications

References 30 publications

Impact of Gender on Satisfaction and Confidence in Cholesterol Control Among Veterans at Risk for Cardiovascular Disease

Impact of Gender on Satisfaction and Confidence in Cholesterol Control Among Veterans at Risk for Cardiovascular Disease

Enrollment and Retention of Men and Women in Health Services Research and Development Trials

Are blood pressure values compatible with medication adherence in hypertensive patients?

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