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Multicenter Study
. 2007 Jun;22(6):768-74.
doi: 10.1007/s11606-007-0165-9. Epub 2007 Mar 16.

Hypertensive patients' race, health beliefs, process of care, and medication adherence

Nancy R Kressin  1 , Fei Wang, Judith Long, Barbara G Bokhour, Michelle B Orner, James Rothendler, Christine Clark, Surekha Reddy, Waldemar Kozak, Laura P Kroupa, Dan R Berlowitz
Affiliations
Multicenter Study

Hypertensive patients' race, health beliefs, process of care, and medication adherence

Nancy R Kressin et al. J Gen Intern Med. 2007 Jun.

Abstract

Background: African Americans have higher rates of hypertension and worse blood pressure (BP) control than Whites, and poorer medication adherence may contribute to this phenomenon. We explored associations among patients' race, self-reported experiences with clinicians, attitudes and beliefs about hypertension, and ultimately, medication adherence, among a sample with no racial disparities in BP control, to determine what lessons we could learn from patients and providers in this setting.

Methods: We recruited 793 White and African-American (58%) patients previously diagnosed with hypertension from 3 VA medical centers to participate in survey assessments of each of the above dimensions, subsequent to a primary care clinic visit.

Results: African-American patients' providers were significantly more active in advising and counseling about hypertension care and medication adherence. African-American patients indicated greater knowledge or heightened awareness of the importance of controlling their BP, but there were no race differences on a summary adherence measure. In multivariate models modeling medication adherence, race was not significant, but having been told to split one's pills, believing one's BP continues to be high, and having one's provider discuss things to do to make it easier to take BP medications were each significantly associated with worse adherence, whereas having more confidence in one's ability to take BP medications as prescribed was associated with better adherence (all p's < or = .02).

Conclusion: When both physicians and patients take BP management seriously, disparities in BP adherence and control may be reduced.

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Figures

Figure 1
Figure 1
The health decision model, adapted from Eraker, Kirscht, and Becker, 1984 .
See this image and copyright information in PMC

References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1001/archinte.157.21.2413', 'is_inner': False, 'url': 'https://doi.org/10.1001/archinte.157.21.2413'}, {'type': 'PubMed', 'value': '9385294', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/9385294/'}]}
    2. Joint National Committee. The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch Intern Med. 1997;157:2413–46. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1056/NEJMsa012979', 'is_inner': False, 'url': 'https://doi.org/10.1056/nejmsa012979'}, {'type': 'PubMed', 'value': '12432046', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/12432046/'}]}
    2. Wong M, Shapiro M, Boscardin W, et al. Contributions of major diseases to disparities in mortality. N Engl J Med. 2002;347:1585–92. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '12461301', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/12461301/'}]}
    2. Cushman WC, Ford CE, Cutler JA, et al. Success and predictors of blood pressure control in diverse North American settings: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). J Clin Hypertens (Greenwich). 2002;4(6):393–404. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PMC', 'value': 'PMC1380739', 'is_inner': False, 'url': 'https://pmc.ncbi.nlm.nih.gov/articles/PMC1380739/'}, {'type': 'PubMed', 'value': '9003143', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/9003143/'}]}
    2. Monane M, Bohn RL, Gurwitz JH, Glynn RJ, Levin R, Avorn J. Compliance with antihypertensive therapy among elderly Medicaid enrollees: the roles of age, gender, and race. Am J Public Health. 1996;86(12):1805–8. - PMC - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '1632999', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/1632999/'}]}
    2. Sharkness CM, Snow DA. The patient’s view of hypertension and compliance. Am J Prev Med. 1992;8:141–6. - PubMed

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