scholarly journals Effects of Emotional Response on Adherence to Antihypertensive Medication and Blood Pressure Improvement

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Robert D. Keeley ◽  
Margaret Driscoll
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Emotional Response ◽  
Antihypertensive Medication ◽  
Primary Outcome ◽  
Secondary Outcome ◽  
Behavioral Risk ◽  
Improve Medication Adherence ◽  
Pharmacy Refill ◽  
Adherence Score

Background. Developing interventions to improve medication adherence may depend upon discovery of novel behavioral risk factors for nonadherence.Objective. Explore the effects of emotional response (ER) on adherence to antihypertensive medication and on systolic blood pressure (SBP) improvement.Design. We studied 101 adults with diabetes and hypertension. The primary outcome, 90-day “percentage of days covered” adherence score, was determined from pharmacy refill records. The secondary outcome was change in SBP over 90 days. ER was classified as positive, negative, or neutral.Results. Average adherence was 71.6% (SD 31.4%), and negative and positive ER were endorsed by 25% and 9% of subjects, respectively. Gender moderated the effect of positive or negative versus neutral ER on adherence (interactionP=0.003); regardless of gender, negative and positive ER were associated with similarly high and low adherence, respectively, but males endorsing neutral ER had significantly higher adherence than their female counterparts (85.6% versus 57.1%,Fvalue = 15.3,P=0.0002). Adherence mediated ER's effect on SBP improvement: among participants with negative, but not positive or neutral, ER, increasing adherence and SBP improvement were correlated (Spearman’sr=0.49,P=0.02).Conclusions. Negative, but not positive or neutral, ER predicted better medication adherence and a correlation between medication adherence and improvement in SBP.

Impact of Electronic Medication Reminder Caps on Patient Adherence and Blood Pressure

2021 ◽  
pp. 875512252110187
Author(s):  
Nicolette Mehas ◽  
Karen Suchanek Hudmon ◽  
Heather Jaynes ◽  
Steve Klink ◽  
Laura Downey ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Patient Adherence ◽  
Medication Possession Ratio ◽  
Self Report ◽  
Secondary Outcome ◽  
Control Group ◽  
Improve Medication Adherence ◽  
Electronic Reminder ◽  
The Impact

Background: Medication adherence is widely recognized as an essential component of chronic disease management, yet only 50% of patients take their medication as prescribed. Newer technologies have the potential to improve medication adherence. Objective: To conduct a pilot study estimating the impact of a pharmacy-dispensed electronic reminder cap (SMARxT cap), which also records cap openings, on medication adherence and blood pressure (BP). Methods: After a 30-day run-in period, 28 individuals were randomized to receive a SMARxT or placebo cap on each BP medication. The primary outcome was adherence measured via (1) the medication possession ratio, (2) number of cap openings, and (3) self-report. The secondary outcome was the average of 2 BP readings at 6 months. Mean changes from baseline to 6 months were compared between the 2 groups. Results: The medication possession ratio increased 2.7% in the SMARxT cap group and decreased 1.1% in the control group ( P = .13), and cap openings increased 11.9% in the SMARxT cap group and 9.9% in the control group ( P = .83). Self-reported adherence increased 1.1 points in the SMARxT cap group and 0.8 points in the control group ( P = .64). Systolic BP decreased 8.2 mm Hg in the SMARxT cap group and 2.8 mm Hg in the placebo cap group ( P = .35), and diastolic BP decreased to 6.2 mm Hg in the SMARxT cap group and was unchanged in the placebo cap group ( P = .06). Conclusions: Use of SMARxT cap showed nonsignificant improvement in medication adherence and BP lowering. This technology has potential to characterize and improve medication-taking behavior.

scholarly journals Association Between Antihypertensive Medication Adherence and Visit-to-Visit Variability of Blood Pressure

2012 ◽  
Vol 15 (2) ◽  
pp. 112-117 ◽  
Author(s):  
Paul Muntner ◽  
Emily B. Levitan ◽  
Cara Joyce ◽  
Elizabeth Holt ◽  
Devin Mann ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Antihypertensive Medication

scholarly journals Using Values Affirmation to Reduce the Effects of Stereotype Threat on Hypertension Disparities: Protocol for the Multicenter Randomized Hypertension and Values (HYVALUE) Trial (Preprint)

2018 ◽  
Author(s):  
Stacie L Daugherty ◽  
Suma Vupputuri ◽  
Rebecca Hanratty ◽  
John F Steiner ◽  
Julie A Maertens ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Medication Adherence ◽  
Racial Disparities ◽  
Stereotype Threat ◽  
Primary Outcome ◽  
Racial Bias ◽  
The United States ◽  
Uncontrolled Hypertension ◽  
Values Affirmation

BACKGROUND Medication nonadherence is a significant, modifiable contributor to uncontrolled hypertension. Stereotype threat may contribute to racial disparities in adherence by hindering a patient’s ability to actively engage during a clinical encounter, resulting in reduced activation to adhere to prescribed therapies. OBJECTIVE The Hypertension and Values (HYVALUE) trial aims to examine whether a values-affirmation intervention improves medication adherence (primary outcome) by targeting racial stereotype threat. METHODS The HYVALUE trial is a patient-level, blinded randomized controlled trial comparing a brief values-affirmation writing exercise with a control writing exercise among black and white patients with uncontrolled hypertension. We are recruiting patients from 3 large health systems in the United States. The primary outcome is patients’ adherence to antihypertensive medications, with secondary outcomes of systolic and diastolic blood pressure over time, time for which blood pressure is under control, and treatment intensification. We are comparing the effects of the intervention among blacks and whites, exploring possible moderators (ie, patients’ prior experiences of discrimination and clinician racial bias) and mediators (ie, patient activation) of intervention effects on outcomes. RESULTS This study was funded by the National Heart, Lung, and Blood Institute. Enrollment and follow-up are ongoing and data analysis is expected to begin in late 2020. Planned enrollment is 1130 patients. On the basis of evidence supporting the effectiveness of values affirmation in educational settings and our pilot work demonstrating improved patient-clinician communication, we hypothesize that values affirmation disrupts the negative effects of stereotype threat on the clinical interaction and can reduce racial disparities in medication adherence and subsequent health outcomes. CONCLUSIONS The HYVALUE study moves beyond documentation of race-based health disparities toward testing an intervention. We focus on a medical condition—hypertension, which is arguably the greatest contributor to mortality disparities for black patients. If successful, this study will be the first to provide evidence for a low-resource intervention that has the potential to substantially reduce health care disparities across a wide range of health care conditions and populations. CLINICALTRIAL ClinicalTrials.gov NCT03028597; https://clinicaltrials.gov/ct2/show/NCT03028597 (Archived by WebCite at http://www.webcitation.org/72vcZMzAB). INTERNATIONAL REGISTERED REPOR DERR1-10.2196/12498

scholarly journals Implicit and Explicit Attitudes Toward Antihypertensive Medications Explain Variation in Pharmacy Refill and Self‐Reported Adherence Beyond Traditional Risk Factors: Potential Novel Mechanism Underlying Adherence

2021 ◽  
Author(s):  
Leslie S. Craig ◽  
Erin Peacock ◽  
Brice L. Mohundro ◽  
Julia H. Silver ◽  
James Marsh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medication Adherence ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Antihypertensive Medication ◽  
Explicit Attitudes ◽  
Pharmacy Refill ◽  
Traditional Risk Factors ◽  
Implicit And Explicit ◽  
Implicit And Explicit Attitudes

Background In pursuit of novel mechanisms underlying persistent low medication adherence rates, we assessed contributions of implicit and explicit attitudes, beyond traditional risk factors, in explaining variation in objective and subjective antihypertensive medication adherence. Methods and Results Implicit and explicit attitudes were assessed using the difference scores from the computer‐based Single Category Implicit Association Test and the Necessity and Concerns subscales of the Beliefs about Medicines Questionnaire, respectively. Antihypertensive medication adherence was measured using pharmacy refill proportion of days covered (PDC: mean PDC, low PDC <0.8) and the self‐report 4‐item Krousel‐Wood Medication Adherence Scale (K‐Wood‐MAS‐4: mean K‐Wood‐MAS‐4, low adherence via K‐Wood‐MAS‐4 ≥1). Hierarchical logistic and linear regression models controlled for traditional risk factors including social determinants of health, explicit, and implicit attitudes in a stepwise fashion. Community‐dwelling insured participants (n=85: 44.7% female; 20.0% Black; mean age, 62.3 years; 43.5% low PDC, and 31.8% low adherence via K‐Wood‐MAS‐4) had mean (SD) explicit and implicit attitude scores of 7.188 (5.683) and 0.035 (0.334), respectively. Low PDC was inversely associated with more positive explicit (adjusted odds ratio [aOR], 0.87; 95% CI, 0.78–0.98; P =0.022) and implicit (aOR, 0.12; 95% CI, 0.02–0.80; P =0.029) attitudes, which accounted for an additional 8.6% ( P =0.016) and 6.5% ( P =0.029) of variation in low PDC, respectively. Lower mean K‐Wood‐MAS‐4 scores (better adherence) were associated only with more positive explicit attitudes (adjusted β, −0.04; 95% CI, −0.07 to −0.01; P =0.026); explicit attitudes explained an additional 5.6% ( P =0.023) of K‐Wood‐MAS‐4 variance. Conclusions Implicit and explicit attitudes explained significantly more variation in medication adherence beyond traditional risk factors, including social determinants of health, and should be explored as potential mechanisms underlying adherence behavior.

scholarly journals 4070 Association of Interpersonal Processes of Care and Health Outcomes in Patients with Type II Diabetes

2020 ◽  
Vol 4 (s1) ◽  
pp. 80-81
Author(s):  
Hadley Reid ◽  
Olivia M Lin ◽  
Rebecca L Fabbro ◽  
Kimberly S Johnson ◽  
Laura P. Svetkey ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Type Ii Diabetes ◽  
Primary Outcome ◽  
Patient Perceptions ◽  
Secondary Outcome ◽  
Diabetic Patients ◽  
Type Ii ◽  
Interpersonal Processes ◽  
Processes Of Care ◽  
Perceptions Of Care

OBJECTIVES/GOALS: 1. Understand the association between patient perceptions of care measured by the Interpersonal Processes of Care (IPC) Survey and glycemic control, appointment no-shows/cancellations and medication adherence in patients with type II diabetes. 2. Determine how these relationships differ by race for non-Hispanic White and Black patients. METHODS/STUDY POPULATION: This is a cross-sectional study of a random sample of 100 White and 100 Black Type II diabetic patients followed in Duke primary care clinics and prescribed antihyperglycemic medication. We will recruit through email and phone calls. Enrolled patients will complete the Interpersonal Processes of Care Short Form and Extent of Medication Adherence survey to measure patient perceptions of care (predictor) and medication adherence (secondary outcome). No show appointments and cancellations (secondary outcomes) and most recent hemoglobin A1c (primary outcome) will be collected from the Electronic Medical Record. We will also collect basic demographic information, insurance status, financial security, significant co-morbidities, and number and type (subcutaneous vs oral) of antihyperglycemic medications. RESULTS/ANTICIPATED RESULTS: -The study is powered to detect a 0.6% difference in HbA1c, our primary outcome, between high and low scorers on the Interpersonal Processes of Care subdomains. -We expect that higher patient scores in the positive domains of the IPC survey and lower DISCUSSION/SIGNIFICANCE OF IMPACT: This study will provide information to develop and implement targeted interventions to reduce racial and ethnic disparities in patients with Type II diabetes. We hope to gain information on potentially modifiable factors in patient-provider interactions that can be intervened upon to improve prevention and long-term outcomes in these populations.

scholarly journals Impact of antihypertensive medication adherence on blood pressure control in hypertension: the COMFORT study

QJM ◽  
2013 ◽  
Vol 106 (10) ◽  
pp. 909-914 ◽  
Author(s):  
K. Matsumura ◽  
H. Arima ◽  
M. Tominaga ◽  
T. Ohtsubo ◽  
T. Sasaguri ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Blood Pressure Control ◽  
Antihypertensive Medication ◽  
Pressure Control

scholarly journals Adherence to antihypertensive medications in patients attending public hospitals in Kano State, Nigeria

2020 ◽  
Vol 12 (1) ◽  
pp. 395-400
Author(s):  
Umar Idris Ibrahim ◽  
Shafiu Mohammed ◽  
Abdulkadir Umar Zezi ◽  
Basira Kankia Lawal
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Antihypertensive Medication ◽  
Public Hospitals ◽  
Poor Adherence ◽  
Chronic Medical Condition ◽  
Public Healthcare ◽  
Good Adherence ◽  
Adherence To Medication ◽  
Arterial Blood

Hypertension is a chronic medical condition characterized by an elevated arterial blood pressure with increasing prevalence in developing countries including Nigeria. One of the integral elements in management of hypertension is adherence to medication and life-style modification. This study aimed to assess adherence level for anti-hypertensive medications among adult hypertensive patients attending public hospitals in Kano State, Nigeria. The study was a cross sectional prospective survey involving 600 patients from six public healthcare facilities selected by multistage sampling technique. Adherence status was assessed using Morisky medication adherence scale. Sociodemographic data and other factors that may influence adherence to hypertension medications were evaluated. Out of the 598 patients that participated in the study, only 178 (29.8%) have their BP controlled based on JNC8. Three hundred and thirty two (55.5%) out of 598 patients have good adherence, while 266 (45.5%) have poor adherence. Of the 178 patients who had good BP control, 120 (67.5%) have good adherence while 58 (32.5%) have poor adherence. BP control was significantly higher in those that adhered to antihypertensive medication compared with non-adhering patients (χ2 = 14.526; df = 1; p-value = < 0.001). Additionally, Chi-square test showed significant association between number of antihypertensives and blood pressure control. (χ2=37.556, df=3, p<0.001). The study established that 55.5% of the respondents have good adherence to their antihypertensive medication while 29.8% had their BP controlled. Adherence and number of antihypertensive medication a patient is taking were found to have significant relationship with BP control. Keywords: Medication, adherence, hypertension, antihypertensive

scholarly journals An Interdisciplinary Collaboration to Improve Hypertension Medication Adherence for Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 229-230
Author(s):  
Jeannie Lee ◽  
Wendy Rogers
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Decision Support ◽  
Medication Adherence ◽  
Cognitive Aging ◽  
Interdisciplinary Collaboration ◽  
Interdisciplinary Team ◽  
Interdisciplinary Teams ◽  
Improve Medication Adherence ◽  
Pressure Feedback

Abstract Hypertension is highly prevalent in older adults (74.5% in ≥60 years) with dire consequences, and adherence to hypertension medications is low (approximately 50%). With increased smartphone use among older adults (81% for 60-69 years, 62% for ≥70 years), technology innovations can improve medication adherence. This symposium highlights the efforts of an innovative interdisciplinary team of experts (clinical, cognitive aging, human factors, health technology) to develop and implement the Medication Education, Decision Support, Reminding, and Monitoring (MEDSReM) system to improve hypertension medication adherence for older adults. MEDSReM is a theory-based, integrated mobile application (app) and companion web portal that educates, supports missed dose decisions, reminds, monitors adherence, and incorporates blood pressure feedback. In this symposium, we describe the interdisciplinary development efforts. Insel et al. will present the theory-based intervention, technology translation, and advancement of the MEDSReM system. Lee et al. will describe the interdisciplinary team and describe the work by the decision support subteam that created the medication formulary and generated an algorithm to guide missed-dose decisions based on pharmacology of aging. Rogers et al. will discuss the education subteam’s development of educational information about hypertension, medications, and adherence for the MEDSReM system. Mitzner et al. will illustrate the instructional support sub-team’s efforts to ensure older adults can interact with both the smartphone app and online portal. Lastly, Hale et al. will describe the user testing subteam’s usability processes including the integration of blood pressure self-monitoring. These efforts will provide insights for other interdisciplinary teams developing technology interventions for older adults.

Sign in / Sign up

Export Citation Format

Share Document