Hypertensive Patients’ Race, Health Beliefs, Process of Care, and Medication Adherence

Kressin, Nancy R.; Wang, Fei; Long, Judith A.; Bokhour, Barbara G.; Orner, Michelle B.; Rothendler, James A.; Clark, Christine; Reddy, Surekha; Kozak, Waldemar; Kroupa, Laura; Berlowitz, Dan R.

doi:10.1007/s11606-007-0165-9

Cited by 86 publications

(77 citation statements)

References 29 publications

(12 reference statements)

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“…The authors of this study suggested that the observed ethnic difference in blood pressure control was due to medication non-adherence [22]. In contrast, an African American study found no ethnic differences in the adherence of drugs in relation to blood pressure, although African Americans did receive better counselling on hypertension care and medication adherence [23]. It should be noted that it was difficult to compare these findings due to the differences in patient origin, migration history and the structure of the health care system.…”

Section: Discussionmentioning

confidence: 73%

Do immigrants from Turkey, Pakistan and Yugoslavia receive adequate medical treatment with beta-blockers and statins after acute myocardial infarction compared with Danish-born residents? A register-based follow-up study

Hempler

Diderichsen

Larsen

et al. 2010

Eur J Clin Pharmacol

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Purpose We undertook a study investigating whether immigrants from Turkey, Pakistan and Yugoslavia received adequate medical treatment with beta-blockers and statins after acute myocardial infarction (AMI) when compared with Danish-born residents and explored whether associations between patient origin and medical treatment were mediated by socioeconomic status (SES). Methods This register-based follow-up study consisted of individuals >17 years of age, admitted to hospital with AMI between 2001 and 2005 (n=25 443). Danish-born residents were compared with immigrants from Turkey, Pakistan and Yugoslavia. Individuals were identified by civil registration number, and data were obtained through linkage to the national registers of hospitalisations and drug prescriptions. Odds of initiating treatment and hazard ratios (HR) of terminating treatment were estimated. Mediators such as income and employment were included in the models. Results Pakistanis were less likely than Danish-born residents to initiate treatment with beta-blockers after AMI [odds ratio 0.52; 95% confidence interval (CI) 0.34-0.80]. Immigrants from Turkey (HR 1.36; 95% CI 1.07-1.73) and Pakistan (HR 1.59; 95% CI 1.21-2.08) were more likely to terminate treatment with beta-blockers before being recommended to do so. Estimates did not change markedly when income and education were included in the models. Conclusions The results of this study suggest that immigrants from Pakistan and Turkey do not receive adequate medical treatment with beta-blockers after a first AMI compared with Danish-born residents. Mediators such as income and employment may not be sufficient indicators of SES when the effect of patient origin on medical treatment is explored. A lower SES of immigrants, communication problems between doctor and patient and doctors' attitudes towards immigrants may explain ethnic differences in medical treatment after AMI.

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Section: Discussionmentioning

confidence: 73%

Do immigrants from Turkey, Pakistan and Yugoslavia receive adequate medical treatment with beta-blockers and statins after acute myocardial infarction compared with Danish-born residents? A register-based follow-up study

Hempler

Diderichsen

Larsen

et al. 2010

Eur J Clin Pharmacol

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“…28 Only one study showed that black patients self-reported greater frequency of counseling by their physician about hypertension and medication adherence compared with whites. 33 Blood pressure control could be considered a measure of health status. Data on the relationship between overall health status and quality of care are inconsistent.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Patient Race and Blood Pressure Control on Patient-Physician Communication

et al. 2009

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BACKGROUND: Racial disparities in hypertension control contribute to higher rates of cardiovascular mortality among blacks. Patient-physician communication quality is associated with better health outcomes, including blood pressure (BP) control. Both race/ethnicity and BP control may adversely affect communication. OBJECTIVE:To determine whether being black and having poor BP control interact to adversely affect patient-physician communication more than either condition alone, a situation referred to as "double jeopardy." DESIGN, SETTINGS, AND PATIENTS:Cross-sectional study of enrollment data from a randomized controlled trial of interventions to enhance patient adherence to therapy for hypertension. Participants included 226 hypertensive patients and 39 physicians from 15 primary care practices in Baltimore, MD. MEASUREMENTS:Communication behaviors and visit length from coding of audiotapes. RESULTS:After controlling for patient and physician characteristics, blacks with uncontrolled BP have shorter visits (B=−3.9 min, p<0.01) with less biomedical (B=−24.0, p=0.05), psychosocial (B=−19.4, p< 0.01), and rapport-building (B=−19.5, p=0.01) statements than whites with controlled BP. Of all communication outcomes, blacks with uncontrolled BP are only in "double jeopardy" for a patient positive affect-coders give them lower ratings than all other patients. Blacks with controlled BP also experience shorter visits and less communication with physicians than whites with controlled BP. There are no significant communication differences between the visits of whites with uncontrolled versus controlled BP.CONCLUSIONS: This study reveals that patient race is associated with the quality of patient-physician communication to a greater extent than BP control. Interventions that improve patient-physician communication should be tested as a strategy to reduce racial disparities in hypertension care and outcomes.

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“…In a study conducted by using the Turkish form of the original MASES, it was determined that medication adherence education given to hypertensive patients resulted in a decrease in patients' medication adherence selfefficacy perceptions and a decrease in blood pressures (5). Furthermore, it was also reported in other studies that blood pressure control rate was better in adherent patients compared to non-adherent patients (24,25) and having knowledge about the disease increased adherence (26). A statistically significant difference in self-efficacy scores between the adherent and non-adherent patients with adherent patients obtaining higher scores on the self-efficacy scale was revealed (27).…”

Section: Discussionmentioning

confidence: 96%

Inflammation is related to unbalanced cardiac autonomic functions in hypertension: an observational study

Hacıhasanoğlu

Gözüm

Çapık

2012

Anadolu Kardiyol Derg

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Objective: Study purpose was to examine the validity of a 13-item short form of the Medication Adherence Self-Efficacy Scale-Short Form (MASES-SF) in an independent sample of 150 hypertensive Turkish patients. Methods: This is a methodological study and 150 adult patients, who are receiving medication for hypertension in the last one year, were included as the study sample. The sample of the study was chosen with the method of simple random sampling. The study was conducted between October 25, 2010 and December 31, 2010 at Family Health Center (FHC). In this study, exploratory and confirmatory factor analyses were used for psychometric evaluation. Cronbach's alpha coefficient was used to evaluate the reliability of the scale. Results: Confirmatory factor analysis showed that all goodness indexes were at acceptable quality: χ 2 =61.72, df=65, p>0.05, GFI=0.99, CFI=1.00, RMSA=0.00. Reliability coefficient of the Turkish adaptation of MASES-SF was found as 0.94 and item-total correlations ranged between 0.13 -0.52. Patients with uncontrolled hypertension had lower self-efficacy scores compared to those with normal blood pressure. Conclusion: This result indicated that the preliminary criterion validity is adequate. Psychometric testing demonstrated satisfactory internal consistency and validity of the instrument for patients in the study group. It can be used confidently in determining and testing interventions to improve medication adherence self-efficacy perceptions and behaviors in hypertensive Turkish patients. The MASES-SF is brief, quick to administer, and capture useful data on medication adherence self-efficacy in hypertensive patients. Bu çalışmada psikometrik değerlendirme için açıklayıcı ve doğrulayıcı faktör analizleri kullanılmıştır. Ölçek güvenirliliğini belirlemek için Cronbach's alfa katsayısı kullanıldı. Bulgular: Doğrulayıcı faktör analizinin tüm indekslerinde kabul edilebilir düzeyde olduğu belirlendi. χ 2 =65 (n=150)=61.72, p>0.05, GFI=0.99, AGFI=0.98, RMSA=0.00, CFI=1.00. Türkçe'ye uyarlanan ilaca uyum öz-etkililik ölçeği kısa formunun güvenirlik katsayısının 0.94 ve madde toplam korelasyonunun 0.13-52 arasında olduğu belirlenmiştir. Kan basınçları kontrol altında olmayan hastaların öz-etkililik puanlarının, kan basınçları normal olan hastalara göre daha düşük olduğu belirlenmiştir. Sonuç: Bu sonuç ölçek geçerliliğinin yeterli olduğunu göstermektedir. Yapılan psikometrik ölçüm, çalışılan gruptaki hastalar için kullanılan ölçe-ğin geçerliliğinin ve iç güvenirliliğinin yeterli olduğunu göstermektedir. Ölçek Türk hipertansif hastalarda ilaca uyum öz-etkililik algılarını ve davranışlarını geliştirmek için yapılan müdahalelerin belirlenmesinde güvenle kullanılabilir. İlaca uyum öz-etkilik ölçeği uygulaması kolay, hipertansif bireylerde ilaca uyum öz-etkililiği hakkında faydalı ve kapsamlı bilgi sağlayan bir ölçektir.

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Hypertensive Patients’ Race, Health Beliefs, Process of Care, and Medication Adherence

Abstract: When both physicians and patients take BP management seriously, disparities in BP adherence and control may be reduced.

Cited by 86 publications

References 29 publications

Do immigrants from Turkey, Pakistan and Yugoslavia receive adequate medical treatment with beta-blockers and statins after acute myocardial infarction compared with Danish-born residents? A register-based follow-up study

Do immigrants from Turkey, Pakistan and Yugoslavia receive adequate medical treatment with beta-blockers and statins after acute myocardial infarction compared with Danish-born residents? A register-based follow-up study

The Effect of Patient Race and Blood Pressure Control on Patient-Physician Communication

Inflammation is related to unbalanced cardiac autonomic functions in hypertension: an observational study

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