| Taking less than prescribed: medication nonadherence and provider-patient relationships in lower-income, rural minority adults with hypertension. | |
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MedLine Citation:
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PMID: 20883231 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Control of hypertension remains poor, and lack of adherence to medication is considered a primary reason. Few studies have examined the reasons for medication nonadherence in African American, lower-income, rural adults receiving medications at no personal cost. Moreover, our understanding of how the provider-patient relationship influences adherence in this population is limited. In this study, the authors (1) examined reasons for taking less medication than prescribed and (2) examined the association between provider-patient variables and medication adherence. A total of 434 participants (94.8% African American) were included. The most frequently endorsed reasons for taking less medication than prescribed were not having blood pressure medicine when it was time to take a dose (36%), running out of medicine (35%), bothered by side effects (29%), and a change in one's daily routine (27%). Nonadherent individuals were significantly more likely to report discomfort with asking the health provider questions (74% vs 63%), were more likely to report that health care visits were stressful (25% vs 16%), and exhibited more depressive symptoms (58% vs 45%). Adherent patients had lower blood pressure (systolic: 133±15.8 mm Hg vs 138±17.6 mm Hg, P value=.002; diastolic: 80±9.8 mm Hg vs 83±11 mm Hg, P value=.003) than individuals who were less adherent. Clinicians providing care to rural, poor hypertensive patients should routinely assess self-management behaviors, logistical barriers, and emotional health. Creating clinical encounters that minimize the stressful nature of the visit and encourage patient question-asking behavior may also be important for the optimal management of hypertension. |
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Authors:
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Michelle Y Martin; Connie Kohler; Young-il Kim; Polly Kratt; Yu-Mei Schoenberger; Mark S Litaker; Heather M Prayor-Patterson; Stephen J Clarke; Shiquina Andrews; Maria Pisu |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Journal of clinical hypertension (Greenwich, Conn.) Volume: 12 ISSN: 1751-7176 ISO Abbreviation: J Clin Hypertens (Greenwich) Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-10-04 Completed Date: 2011-03-15 Revised Date: 2011-12-21 |
Medline Journal Info:
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Nlm Unique ID: 100888554 Medline TA: J Clin Hypertens (Greenwich) Country: United States |
Other Details:
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Languages: eng Pagination: 706-13 Citation Subset: IM |
Copyright Information:
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© 2010 Wiley Periodicals, Inc. |
Affiliation:
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Department of Medicine, Division of Preventive Medicine, the School of Public Health, Health Behavior, University of Alabama at Birmingham, Birmingham, AL 35294-4410, USA. mymartin@uab.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult African Americans Aged Antihypertensive Agents / therapeutic use* Attitude to Health / ethnology* Female Humans Hypertension / drug therapy*, ethnology* Male Medication Adherence* Middle Aged Physician-Patient Relations Poverty Rural Population Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL 69375/HL/NHLBI NIH HHS; R01 HL069375-03/HL/NHLBI NIH HHS; R01 HL069375-04/HL/NHLBI NIH HHS; R01 HL069375-04S1/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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