The Impact of COVID-19 on Hypertension and Hypertension Medication Adherence Among Underrepresented Racial and Ethnic Groups: A Scoping Review

Foster, Marva; Etchin, Anna; Pope, Charlene; Hartmann, Christine W.; Emidio, Oluwabunmi; Bosworth, Hayden B.

doi:10.1007/s11906-023-01262-4

Cited by 3 publications

(3 citation statements)

References 44 publications

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“…In this context, community health initiatives such as home monitoring, lifestyle counseling, and follow-up calls have shown efficacy in improving treatment adherence and identifying access issues to medications (25,26). However, in Peru, telemedicine faces challenges in incorporating digital interventions due to the lack of internet access, especially in rural areas like the jungle and highlands (27,28). As a result, interventions derived from this service for populations with chronic diseases are confined to urban areas (29).…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic Inequalities in Non-Adherence to Antihypertensive Medication in Peru

Intimayta-Escalante,

Quintana-García

2024

Preprint

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IntroductionIn Peru, adherence to antihypertensive treatment ranges from 55.5% to 46.6%. Adherence decreases under adverse socioeconomic conditions. Therefore, the aim of this research was to evaluate the socioeconomic inequalities in non-adherence to antihypertensive medication in Peru.MethodsA cross-sectional study was conducted through the analysis of data from the Demographic and Family Health Survey carried out in Peru between 2013 and 2023. We addressed the socioeconomic conditions of hypertensive Peruvian adults, including sex, age group, educational level, area or place of residence, and health insurance. These conditions were evaluated as sources of inequality in non-adherence to antihypertensive medication at a general level using the Concentration Index (CI) or Erreygers’ Correction Index (ECI) among adults over 29 years of age.ResultsIn the 15,624 hypertensive adults over 29 years old included in the study, the 86.63% had adherence to their antihypertensive medication. However, the inequality in non-adherence to medication was considerable (CI: -0.259; 95%CI: -0.385 to -0.132; p¡0.001). This inequality was greater among those aged 30 to 49 years (CI: -0.064; 95%CI: -0.121 to -0.008; p=0.01-0.2), those living in rural areas (CI: -0.484; 95%CI: -0.537 to -0.430; p¡0.001) or outside the capital (CI: -0.495; 95%CI: -0.569 to -0.422; p¡0.001), and those with no education (CI: -0.156; 95%CI: -0.201 to -0.112; p¡0.001) or only primary education (CI: -0.323; 95%CI: -0.386 to -0.260; p¡0.001). In contrast, hypertensive adults with a university education had a positive CI (CI: 0.257; 95%CI: 0.199 to 0.316; p¡0.001).ConclussionHypertensive Peruvian adults residing in rural areas or outside the capital, and those with a low educational level, exhibited greater inequality in adherence to antihypertensive medication.

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Section: Discussionmentioning

confidence: 99%

Socioeconomic Inequalities in Non-Adherence to Antihypertensive Medication in Peru

Intimayta-Escalante,

Quintana-García

2024

Preprint

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“…[16,17] A scoping review of barriers to antihypertensive medication adherence found that the COVID-19 pandemic did not introduce new barriers but did exacerbate pre-existing barriers of access and cost for disadvantaged populations. [18] Although our study was able to capture all prescription medication dispensations from community pharmacies for all adults in the Canadian province of Alberta regardless of their disease or insurance status, there are some limitations to our work.…”

Section: Discussionmentioning

confidence: 99%

Impact of the Covid-19 Pandemic on Adherence to Cardiovascular Medications Among Chronically Treated Patients in Alberta

McAlister,

Savu,

Chu

et al. 2024

Preprint

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Background:Some studies have suggested that the COVID-19 pandemic negatively impacted patient adherence with chronic therapies. We designed this study to explore whether cardiovascular drug adherence patterns changed in chronically treated patients during the COVID-19 pandemic.Methods:Retrospective cohort study examining drug dispensation data for all Alberta residents older than 18 years who were chronic users of at least one cardiovascular drug class, defined as receiving at least one prescription per annum for any agent in that drug class from March 15, 2017 to March 14, 2023 and 2 or more prescriptions within 365 days during either the pre-pandemic phase (March 15, 2018 to March 14, 2020) or the pandemic phase (March 15, 2020 to March 14, 2022). We calculated the proportion of days covered (PDC) for each drug class per patient and used generalized estimating equation logistic regression to estimate the effect of time period (pandemic versus pre-pandemic) on achievement of good adherence (PDC>0.8) after adjusting for age, sex, socioeconomic status, and comorbidities.Results:We evaluated 548,601 chronic users of at least one cardiovascular drug class between March 15, 2018 and March 14, 2022. The most frequently dispensed cardiovascular drug classes were ACEi/ARB (67.6%), statins (53.8%), beta-blockers (21.0%), and calcium channel blockers (20.7%); the most frequent diagnoses were hypertension (77.2%), diabetes mellitus (30.6%), and ischemic heart disease (19.6%), although 55.4% of the patients had Charlson Comorbidity Index scores of 0. The mean PDC for cardiovascular drug use in our cohort was 85.7% (median 93%) pre-pandemic and 87.0% (median 94%) during the pandemic. The proportion exhibiting good adherence (PDC>0.8) increased from 72.8% pre-pandemic to 75.4% during the pandemic (p<0.001). During the pandemic, users of cardiovascular drugs were more likely to exhibit good adherence (PDC>0.8) than they were in the pre-pandemic period: aOR ranged from 1.05 (95%CI 1.00-1.11) for mineralocorticoid receptor antagonists to 1.16 (1.15-1.17) for statins.Conclusion:Chronic users of cardiovascular drugs exhibited higher adherence measures during the COVID-19 pandemic than prior to the pandemic.

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“…Low adherence rates among patients with Medicare are especially concerning in racial and ethnic minorities compared to White patients, with studies showing that Black and Hispanic patients are significantly less likely to be adherent than White patients [10,[12][13][14][15][16]. During the COVID-19 pandemic, patients with Medicare were allowed to fill their medications early and for larger amounts, which helped maintain adherence levels but did not improve the disparity between White and minority patients [17]. Men tend to be more non-adherent than women [16].…”

Section: Introductionmentioning

confidence: 99%

Hypertension Medication and Medicare Beneficiaries: Prescription Drug Coverage Satisfaction and Medication Non-Adherence among Older Adults

Park,

Kim,

Medina

et al. 2024

Healthcare

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Hypertension is so prevalent and requires strict adherence to medications to prevent further disease or death, but there is no study examining factors related to prescription drug non-adherence among 65 years old and older. This study aims to assess the likelihood of medication nonadherence among patients based on factors such as age, race, and socioeconomic status, with the goal of identifying strategies to enhance medication adherence and mitigate associated health risks. Using the 2020 Medicare Current Beneficiary Survey Public Use File to represent nationwide Medicare beneficiaries (unweighted n = 3917, weighted n = 27,134,782), medication non-adherence was related to multiple independent variables (i.e., age, sex, race/ethnicity, socioeconomic status, comorbidities, insurance coverage, and satisfaction with insurance). Cross-tabulations and Wald chi-square tests were used to determine how much each variable was related to non-adherence. Multivariate logistic regression was used to examine the association between medication non-adherence and factors such as prescription drug coverage satisfaction and cost-reducing behavior. Specific trends in medication non-adherence emerged among beneficiaries. Non-adherence was higher in older adults aged 65- to 74-year-olds and those with more chronic conditions (OR = 2.24; 95% CI = 1.74–2.89). If patients were dissatisfied with the medications on the insurance formulary or struggled to find a pharmacy that accepted their medication coverage, they had worse adherence (OR = 2.63; 95% CI = 1.80–3.84). Formulary and coverage must be expanded to improve adherence to antihypertensive medications in Medicare beneficiaries. Older adults aged 65 to 74 years may be less adherent to their medications because they do not see the seriousness of the disease and could benefit from further counseling. Patients with limited activities of daily living and more comorbidities may struggle with complex treatment regimens and should use adherence assistance tools.

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The Impact of COVID-19 on Hypertension and Hypertension Medication Adherence Among Underrepresented Racial and Ethnic Groups: A Scoping Review

Cited by 3 publications

References 44 publications

Socioeconomic Inequalities in Non-Adherence to Antihypertensive Medication in Peru

Socioeconomic Inequalities in Non-Adherence to Antihypertensive Medication in Peru

Impact of the Covid-19 Pandemic on Adherence to Cardiovascular Medications Among Chronically Treated Patients in Alberta

Hypertension Medication and Medicare Beneficiaries: Prescription Drug Coverage Satisfaction and Medication Non-Adherence among Older Adults

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