Appointment-Keeping Behavior is Not Related to Medication Adherence in Hypertensive African Americans

Abstract

OBJECTIVE:The relationship between appointmentkeeping behavior, medication adherence (ADH), and systolic and diastolic blood pressure (SBP and DBP) was assessed in 153 hypertensive African Americans followed in a community-based practice.METHODS: ADH was assessed with a self-report questionnaire. BP was obtained from electronic medical records and appointment attendance was determined from the log of all appointments made during the 12-month study period. Nonadherence rates were compared across appointment attendance categories with chi-square. Logistic regression was used to assess the relationship between ADH and appointment attendance, whereas multivariate analysis of covariance (MANCOVA) was used to examine the relationship between appointment attendance and BP.RESULTS: Twenty-five percent of patients (87% women, mean age 52 years) did not miss any appointments, 44% missed 1-30%, and 31% missed greater than 30%. Adjusted nonadherence rates were similar for all 3 categories (70%, 66%, and 65%, respectively, p=0.88) as were adjusted mean SBP and DBP in the MANCOVA model, [F (4, 218)=1.13, p=.34]. Logistic regression analysis did not indicate a significant relationship between appointment attendance and ADH.

Predictors of Changes in Medication Adherence in Blacks with Hypertension: Moving Beyond Cross-Sectional Data

“…The Morisky scale has been used in other studies of black patients with HTN. (35-37) In our sample, the Cronbach's alpha was 0.67, which is consistent with the estimate of Morisky et al(34)…”

Missed medical appointment among hypertensive and diabetic outpatients in a tertiary healthcare facility in Ibadan, Nigeria

“…A similar rate of 12.0 % was reported in a cross-sectional survey of 185 hypertensive African-Americans in an urban medical center in Maryland, USA [3]. However, as high as 31.0 % of hypertensive African-Americans followed in a community based practice in New York City missed more than 30.0 % of follow-up appointments [15]. Among the diabetic respondents in this study, 13.0 % missed more than 30 % of their follow-up appointments.…”

“…Findings from this study aligned with those of other investigators who suggest that appointment adherence is not an accurate substitute for medication taking behavior. For instance, in a cross-sectional study, Ogedegbe and his colleagues found no significant relationship between appointment adherence and medication adherence among 190 hypertensive African-Americans followed in a community health center in New York [15]. ].…”

“…This was defined by evaluating the distribution of responses to the question "Out of every 10 appointments, on an average how many did you miss?" Missed appointment rates were then grouped into 3 categories: 0 %, 1-30 % and > 30 % using cutoffs from previous adherence studies [3,4,15].…”

Barriers to adherence and hypertension control in a racially diverse representative sample of elderly primary care patients

“…40 Missing physician office visits was also not associated with adherence as in another study of minority hypertensive patients. 41 Finally, elderly patients who were prescribed at least four antihypertensive medications were less adherent, as in other studies. 29 In response to an elevated blood pressure, physicians may simply add another drug instead of counselling about medication adherence.…”