Document Detail


Predictors, barriers, and facilitators of lipid-lowering medication use among African Americans in a primary care clinic.
MedLine Citation:
PMID:  19806853     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
INTRODUCTION: Hypercholesterolemic African Americans are less likely than white Americans to be taking lipid-lowering medications, yet they suffer disproportionately from coronary heart disease (CHD). METHODS: Through medical record abstraction and focus groups with patients and physicians, we sought a better understanding of the predictors, barriers, and facilitators to lipid-lowering medication use in a Detroit primary care clinic. Stepwise regression analysis included 634 African American patients with abnormal cholesterol values (n = 575) or currently prescribed a lipid-lowering medication (n = 59). Focus group transcripts were analyzed with a framework approach. RESULTS: Overall 174 (30.3%) of hypercholesterolemic African Americans were prescribed a lipid-lowering medication. Patients with hypertension or CHD were significantly more likely to have a lipid-lowering medication prescription than those without, adjusted prevalence ratio 2.56 (95% CI, 1.76-3.74) for hypertension and 1.70 (95% CI, 1.45-2.00) for CHD. Focus groups revealed 2 barriers to lipid-lowering medication use named by both physicians (n = 12) and patients (n = 23): cost and forgetting to take medication, often because of lack of symptoms. CONCLUSIONS: Physicians and patients suggested better education by physicians and at the community level to improve lipid-lowering medication use. Simple and direct patient-physician discussions emphasizing long-term benefits are recommended.
Authors:
Kendra L Schwartz; Rhonda Dailey; Monina Bartoces; Juliann Binienda; Carolyn Archer; Anne Victoria Neale
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the National Medical Association     Volume:  101     ISSN:  0027-9684     ISO Abbreviation:  J Natl Med Assoc     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-10-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7503090     Medline TA:  J Natl Med Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  944-52     Citation Subset:  IM    
Affiliation:
Department of Family Medicine, Wayne State University School of Medicine, Detroit, Michigan 48201, USA. kensch@med.wayne.edu
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MeSH Terms
Descriptor/Qualifier:
Grant Support
ID/Acronym/Agency:
D12HP00175//PHS HHS

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