Prevalence and Predictors of Poor Antihypertensive Medication Adherence in an Urban Health Clinic Setting

Abstract

Poor medication adherence may contribute to low hypertension control rates. In 2005, 295 hypertensive patients who reported taking antihypertensive medication were administered a telephone questionnaire including an 8-item scale assessing medication adherence. Overall, 35.6%, 36.0%, and 28.4% of patients were determined to have good, medium, and poor medication adherence, respectively. After multivariable adjustment, adults younger than 50 years and 51 to 60 years were 1.39 (95% confidence interval [CI], 0.56-3.42) and 1.53 (95% CI, 0.64-3.66), respectively, times more likely to be less adherent when compared with their counterparts who were older than 60 years. Black adults and men were 4.30 (95% CI, 1.06-17.5) and 2.45 (95% CI, 1.04-5.78) times more likely to be less adherent, respectively. Additionally, caring for dependents, an initial diagnosis of hypertension within 10 years, being uncomfortable about asking the doctor questions, and wanting to spend more time with the doctor if possible were associated with poor medication adherence. The current study identified a set of risk factors for poor antihypertensive medication adherence in the urban setting.

Health Coaching to Improve Hypertension Treatment in a Low-Income, Minority Population

“…2 Failures in hypertension management can be attributed to 4 factors: poor patient understanding of physician instructions, lack of patient participation in decision making, low medication adherence, and clinical inertia. Fifty percent of patients leave the physician visit not understanding physician instructions 3 ; patients rarely participate in clinical decisions, 4 and those who do have better outcomes 5 ; only 36% to 39% of underserved patients adhere to antihypertensive medications 6,7 ; and these medications are increased in only 13% of visits in which blood pressure is elevated. 8 Furthermore, because 79% of hypertension visits occur in pri-…”

Do socioeconomic disparities affect accessing and keeping antihypertensive drug therapy? Evidence from an Italian population-based study

“…2,3 Socioeconomic factors, such as income, education and ethnicity, have been extensively investigated as possibly associated with the rate of treatment and control of hypertension. [4][5][6][7][8][9] However, data on this issue mainly reflect private, or mixed publicprivate, health care systems. Despite the fact that the Italian National Health Service (NHS) provides universal coverage for health care, including drug treatment for hypertension, socioeconomic disparities in the occurrence of coronary heart disease still persist.…”

The Effect of Patient Race and Blood Pressure Control on Patient-Physician Communication

“…9 However, blacks report lower rates of adherence to antihypertensive treatments. 10,11 Adherence barriers that may contribute to racial disparities in CVD outcomes include socioeconomic factors, [12][13][14] patient factors, [15][16][17] health-care access, 13,14,18 and physician communication skills. 19,20 Patient-physician communication is the primary process by which medical decisions are made and patients are diagnosed and treated.…”