Many physicians face the problem of nonadherence among their hypertensive patient population. During the first year of treatment 16-50% of patients stop taking their high blood pressure medication. Overall, it is estimated that only about 30%-50% of patients with hypertension adhere precisely to their hypertension medication regimens. In an effort to improve rates of blood pressure control among underrepresented clinic populations, a four-year study was implemented in a large teaching hospital on the west coast. Thirteen hundred and sixty seven African American (75%) and Hispanic American (25%) adults participated in the longitudinal study. In order to assess patient's medication-taking behavior, a 9-item scale was developed and presented to all patients during their medical-treatment program. Reliability of the measure, as determined by internal consistency, was found to be 0.89. Individuals scoring high on the self-reported measure were significantly more likely to have their blood pressure under control compared to individuals who scored lower. A total of 74% of individuals scoring high on the compliance scale had their blood pressure under control compared to 48% of individuals scoring low (p < .001). Patient variables highly correlated with blood pressure control include forgetfulness, lack of understanding, health beliefs, previous history of nonadherence, poor provider/patient communication and lack of social support. Treatment variables include complexity of the regimen and long waiting time. These results indicate that health care providers can influence significantly the adherence behavior of their patients. Health care providers can support and reinforce current positive behaviors or clarify misunderstandings and incorrect beliefs.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1.Distinguish among various methods to assess medication-taking behavior 2.Describe the components of a reliable and valid method to assess medication-taking behvior 3.List two patient related and two provider related factors significantly predictive of enhancing medication-taking behavior, 3.Develop a care plan for a family of six supported by an annual income of $32,000, and caring for a child who has cystic fibrosis.
Keywords: Adherence, Assessments
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