Taking less than prescribed

Medication nonadherence and provider-patient relationships in lower-income, rural minority adults with hypertension

Michelle 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

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)706-713
Number of pages8
JournalJournal of Clinical Hypertension
Volume12
Issue number9
DOIs
StatePublished - Sep 1 2010

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Medication Adherence
Hypertension
African Americans
Medicine
Blood Pressure
Health
Patient Compliance
Self Care
Depression
Delivery of Health Care
Costs and Cost Analysis
Population

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

Cite this

Taking less than prescribed : Medication nonadherence and provider-patient relationships in lower-income, rural minority adults with hypertension. / Martin, Michelle; Kohler, Connie; Kim, Young il; Kratt, Polly; Schoenberger, Yu Mei; Litaker, Mark S.; Prayor-Patterson, Heather M.; Clarke, Stephen J.; Andrews, Shiquina; Pisu, Maria.

In: Journal of Clinical Hypertension, Vol. 12, No. 9, 01.09.2010, p. 706-713.

Research output: Contribution to journalArticle

Martin, M, Kohler, C, Kim, YI, Kratt, P, Schoenberger, YM, Litaker, MS, Prayor-Patterson, HM, Clarke, SJ, Andrews, S & Pisu, M 2010, 'Taking less than prescribed: Medication nonadherence and provider-patient relationships in lower-income, rural minority adults with hypertension', Journal of Clinical Hypertension, vol. 12, no. 9, pp. 706-713. https://doi.org/10.1111/j.1751-7176.2010.00321.x
Martin, Michelle ; Kohler, Connie ; Kim, Young il ; Kratt, Polly ; Schoenberger, Yu Mei ; Litaker, Mark S. ; Prayor-Patterson, Heather M. ; Clarke, Stephen J. ; Andrews, Shiquina ; Pisu, Maria. / Taking less than prescribed : Medication nonadherence and provider-patient relationships in lower-income, rural minority adults with hypertension. In: Journal of Clinical Hypertension. 2010 ; Vol. 12, No. 9. pp. 706-713.
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