Hypertension in multicultural and minority populations: Linkin communication to compliance

Betancourt, Joseph R.; Carrillo, J. Emilio; Green, A R

doi:10.1007/bf03215777

Cited by 111 publications

(62 citation statements)

References 60 publications

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“…Currently there are no evidence-based interventions specifically to improve psychotropic medication adherence among Latinos. However, findings from broader quality improvement interventions (74), adherence interventions in predominantly non-Latino populations (75, 76), adherence interventions for non-psychiatric diseases tested in Latinos (77–79), broader mental health interventions for Latinos (80, 81), from clinical experience (82) and policy papers (39) are potentially applicable.…”

Section: Discussionmentioning

confidence: 99%

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Lanouette¹,

Folsom²,

Sciolla³

et al. 2009

Psychiatric Services

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Objective Psychotropic medication nonadherence is a major public health problem, but few studies have focused on Latinos. We systematically reviewed the literature on rates of and factors influencing antipsychotic, antidepressant, or mood stabilizer nonadherence among United States (US) Latinos. Methods Data Sources: MEDLINE and PsycINFO were searched using keywords adherence, compliance, Latino, Hispanic, psychotropic, and related terms, as well as bibliographies from relevant reviews and studies. Study Selection: 21 studies met inclusion criteria: published since 1980 in English or Spanish; measured psychotropic medication nonadherence rates among US Latino adults. Data Abstraction: We examined articles for study design and objective, location, population, medication type, participant demographics, adherence measure, adherence rates, and factors related to adherence. Results and Conclusions In studies including Latinos and other ethnic groups, mean nonadherence rates were 41%, 31%, and 43% among Latinos, Euro-Americans, and African Americans respectively, with an overall effect size of 0.64 between Latinos and Euro-Americans. In studies including only Latinos, the mean nonadherence rate was 44%. Ten of 16 studies found Latinos had significantly lower adherence rates than Euro-Americans. Risk factors for nonadherence included being monolingual Spanish speaking, lacking health insurance, experiencing barriers to quality care, and having lower socioeconomic status. Protective factors included family support and psychotherapy. Rates of nonadherence to psychotropic medications were higher for Latinos than for Euro-Americans. Further investigation is needed into the potentially modifiable individual and societal level mechanisms of this discrepancy. Clinical and research interventions to improve adherence should be culturally appropriate and incorporate identified factors.

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Section: Discussionmentioning

confidence: 99%

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Lanouette¹,

Folsom²,

Sciolla³

et al. 2009

Psychiatric Services

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“…96 ESFT takes into account 4 domains that influence patient satisfaction, adherence to recommended therapy, and health outcomes. It was initially developed for treating hypertension but can be applied to other illnesses.…”

mentioning

confidence: 99%

Depression in US Hispanics: Diagnostic and Management Considerations in Family Practice

Lewis‐Fernández¹,

Das²,

Alfonso³

et al. 2005

The Journal of the American Board of Family Medicine

217

143

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US Hispanics, currently the largest minority group in the country, face disparities in the recognition and treatment of major depression. This article provides an evidence-based review of the prevalence, presentation, and management of major depression in primary care in this heterogeneous ethnic group. Under-recognition of depression in adult Hispanic Americans may be related to language differences, health literacy barriers, somatic presentations, and use of cultural idioms of distress. Hispanic patients are often agreeable to treatment but as a group may tend to prefer psychotherapy or combined counseling and medication to pharmacotherapy alone. Recent studies have found both psychological and pharmacologic treatment options are efficacious in this minority group. Treatment adherence should be actively monitored to help ensure its effectiveness. To help reduce the number of depressed Hispanic patients who pass through primary care undetected or inadequately treated, family physicians should make a concerted effort to increase their awareness of the presentation of major depression in this population and actively promote adherence to effective treatments.

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“…A small number of studies suggest racial and ethnic disparities may result, in part, from patient-level factors, including minority patients' longer delays before seeking care and a greater likelihood to refuse recommended services [10,29,55,60]. However, such differences are small and appear to contribute only minimally to observed disparities [61].…”

Section: Where Are We Now? the Patientmentioning

confidence: 99%

Getting to Equal: Strategies to Understand and Eliminate General and Orthopaedic Healthcare Disparities

Dykes

White

2009

Clinical Orthopaedics &Amp; Related Research

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The 2001 Institute of Medicine report entitled Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care pointed out extensive healthcare disparities in the United States even when controlling for disease severity, socioeconomic status, education, and access. The literature identifies several groups of Americans who receive disparate healthcare: ethnic minorities, women, children, the elderly, the handicapped, the poor, prisoners, lesbians, gays, and the transgender population. Disparate healthcare represents an enormous current challenge with substantial moral, ethical, political, public health, public policy, and economic implications, all of which are likely to worsen over the next several decades without immediate and comprehensive action. A review of recent literature reveals over 100 general and specific suggestions and solutions to eliminate healthcare disparities. While healthcare disparities have roots in multiple sources, racial stereotypes and biases remain a major contributing factor and are prototypical of biases based on age, physical handicap, socioeconomic status, religion, sexual orientation or other differences. Given that such disparities have a strong basis in racial biases, and that the principles of racism are similar to those of other ''isms'', we summarize the current state of healthcare disparities, the goals of their eradication, and the various potential solutions from a conceptual model of racism affecting patients (internalized racism), caregivers (personally mediated racism), and society (institutionalized racism).

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Hypertension in multicultural and minority populations: Linkin communication to compliance

Cited by 111 publications

References 60 publications

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

Depression in US Hispanics: Diagnostic and Management Considerations in Family Practice

Getting to Equal: Strategies to Understand and Eliminate General and Orthopaedic Healthcare Disparities

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