Reexamining medication adherence in black patients with hypertension through the lens of the social determinants of health

Abstract

Despite the prominent place of health disparities on the national research agenda over the past 2 decades, 1 marked racial and ethnic disparities in hypertension between blacks and whites still persist.

Evaluation of Aspirin and Statin Therapy Use and Adherence in Patients With Premature Atherosclerotic Cardiovascular Disease

“…Although clinical evidence of statin-associated adverse effects based on patient age is lacking, the perceived statin-associated adverse effects among the premature ASCVD population may be another factor in statin discontinuation and lower adherence rates. As previously reported, social determinants, such as health literacy and social support, may be associated with medication adherence . Hence, in the present study, the suboptimal adherence observed among patients with premature or extremely premature ASCVD may be attributed in part to socioeconomic factors.…”

“…As previously reported, social determinants, such as health literacy and social support, may be associated with medication adherence. 48 Hence, in the present study, the suboptimal adherence observed among patients with premature or extremely premature ASCVD may be attributed in part to socioeconomic factors. Statin misinformation or misconceptions because of a greater reliance on social media–based or non–clinician-based resources and a comparative lack of experience in long-term medication management 49 may contribute to lower rates of statin adherence in patients, especially in those with premature ASCVD.…”

Partnerships to Improve Shared Decision Making for Patients with Hypertension: Health Equity Implications

“…Moreover, these consequences may differentially affect certain patient subgroups and thereby affect adherence to treatment plans. [15][16][17]…”

Racial Differences and Social Determinants of Health in Achieving Hypertension Control

“…[28][29][30][31][32] Medication adherence is strongly associated with social determinants, and approaches to improve medication adherence include efforts to promote patient activation, text messaging, consumer-directed care, and pharmacist-led engagement, all of which were integral features of our digital hypertension program. 33,34 Disparities in health outcomes are prevalent when Black patients are compared with White patients, including heart disease, diabetes, cancer, maternal mortality, and infant mortality. [35][36][37][38] Hypertension prevalence and control rates mirror these differences.…”