Medication Complexity among Disadvantaged African American Seniors in Los Angeles

Adinkrah, Edward; Bazargan, Mohsen; Wisseh, Cheryl; Assari, Shervin

doi:10.3390/pharmacy8020086

Cited by 6 publications

(4 citation statements)

References 41 publications

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“…In addition, we documented that, after adjusting for other relevant factors, non-adherence to drug regimens is more prevalent among our sample of underserved African American and Latino older adults with low back pain. Medication-related challenges, including polypharmacy (excessive and unnecessary use of medication), inappropriate medication use, and non-adherence to drug regimens among minority adults, particularly among African Americans, have recently received attention among researchers [ 53 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ]. Limited available data showed increased medication-related challenges among minority older adults compared to their White counterparts [ 53 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ].…”

Section: Discussionmentioning

confidence: 99%

“…Medication-related challenges, including polypharmacy (excessive and unnecessary use of medication), inappropriate medication use, and non-adherence to drug regimens among minority adults, particularly among African Americans, have recently received attention among researchers [ 53 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ]. Limited available data showed increased medication-related challenges among minority older adults compared to their White counterparts [ 53 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ]. Polypharmacy remains an important issue among underserved older minority adults [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

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Multi-Dimensional Impact of Chronic Low Back Pain among Underserved African American and Latino Older Adults

Bazargan

Loeza

Ekwegh

et al. 2021

IJERPH

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Chronic low back pain is one of the most common, poorly understood, and potentially disabling chronic pain conditions from which older adults suffer. The existing low back pain research has relied almost exclusively on White/Caucasian participant samples. This study examines the correlates of chronic low back pain among a sample of underserved urban African American and Latino older adults. Controlling for age, gender, race/ethnicity, education, living arrangement, and number of major chronic conditions, associations between low back pain and the following outcome variables are examined: (1) healthcare utilization, (2) health-related quality of life (HR-QoL) and self-rated quality of health; and (3) physical and mental health outcomes. Methods: We recruited nine hundred and five (905) African American and Latino older adults from the South Los Angeles community using convenience and snowball sampling. In addition to standard items that measure demographic variables, our survey included validated instruments to document HR-QoL health status, the Short-Form McGill Pain Questionnaire-2, Geriatric Depression Scale, sleep disorder, and healthcare access. Data analysis includes bivariate and 17 independent multivariate models. Results: Almost 55% and 48% of the Latino and African American older adults who participated in our study reported chronic low back pain. Our data revealed that having low back pain was associated with three categories of outcomes including: (1) a higher level of healthcare utilization measured by (i) physician visits, (ii) emergency department visits, (iii) number of Rx used, (iv) a higher level of medication complexity, (v) a lower level of adherence to medication regimens, and (vi) a lower level of satisfaction with medical care; (2) a lower level of HR-QoL and self-assessment of health measured by (i) physical health QoL, (ii) mental health QoL, and (iii) a lower level of self-rated health; and (3) worse physical and mental health outcomes measured by (i) a higher number of depressive symptoms, (ii) a higher level of pain, (iii) falls, (iv) sleep disorders, (v) and being overweight/obese. Discussion: Low back pain remains a public health concern and significantly impacts the quality of life, health care utilization, and health outcomes of underserved minority older adults. Multi-faceted and culturally sensitive interventional studies are needed to ensure the timely diagnosis and treatment of low back pain among underserved minority older adults. Many barriers and challenges that affect underserved African American and Latino older adults with low back pain simply cannot be addressed in over-crowded EDs. Our study contributes to and raises the awareness of healthcare providers and health policymakers on the necessity for prevention, early diagnosis, proper medical management, and rehabilitation policies to minimize the burdens associated with chronic low back pain among underserved older African American and Latino patients in an under-resourced community such as South Los Angeles.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Multi-Dimensional Impact of Chronic Low Back Pain among Underserved African American and Latino Older Adults

Bazargan

Loeza

Ekwegh

et al. 2021

IJERPH

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“…The findings of Adepoju and colleagues (2022) revealed minority groups like African Americans and Hispanics who lived further away from healthcare facilities found telehealth very beneficial [69]. However, our study focused on older African Americans, who reside in one of the under-resourced urban communities in the nation and face multiple other socioeconomic and health disparities [70][71][72][73]. Moreover, the high expense of technology, inadequate internet connectivity, poor accessibility for the impaired, and the prevalence of low-performing gadgets all contribute to a general lack of access to technology.…”

Section: Limitationsmentioning

confidence: 90%

Factors Associated with Telehealth Utilization among Older African Americans in South Los Angeles during the COVID-19 Pandemic

Ekwegh

Cobb

Adinkrah

et al. 2023

IJERPH

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Background: The COVID-19 pandemic transformed healthcare delivery with the expansive use of telemedicine. However, health disparities may result from lower adoption of telehealth among African Americans. This study examined how under-resourced, older African Americans with chronic illnesses use telehealth, including related sociodemographic and COVID-19 factors. Methods: Using a cross-sectional design, 150 middle-aged and older African Americans were recruited from faith-based centers from March 2021 to August 2022. Data collected included sociodemographics, comorbidities, technological device ownership, internet usage, and attitudes toward COVID-19 disease and vaccination. Descriptive statistics and multivariable regression models were conducted to identify factors associated with telehealth use. Results: Of the 150 participants, 32% had not used telehealth since the COVID-19 pandemic, with 75% reporting no home internet access and 38% having no cellular/internet network on their mobile device. Age, access to a cellular network on a mobile device, and wireless internet at home were significantly associated with the utilization of telehealth care. Higher anxiety and stress with an increased perceived threat of COVID-19 and positive attitudes toward COVID-19 vaccination were associated with telehealth utilization. Discussion: Access and integration of telehealth services were highlighted as challenges for this population of African Americans. To reduce disparities, expansion of subsidized wireless internet access in marginalized communities is necessitated. Education outreach and training by healthcare systems and community health workers to improve uptake of telehealth currently and post-COVID-19 should be considered.

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“…and principal investigator (C.W.) in prior work [ 12 , 25 ]. The patient-level and diabetes-specific MRC indices were calculated for all patients included in the study solely by this author (L.O.).…”

Section: Methodsmentioning

confidence: 99%

Associations between Diabetes-Specific Medication Regimen Complexity and Cardiometabolic Outcomes among Underserved Non-Hispanic Black Adults Living with Type 2 Diabetes Mellitus

Wisseh,

Adinkrah,

Opara

et al. 2024

Pharmacy

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Type 2 diabetes mellitus (T2DM) management and glycemic control in underserved non-Hispanic Black adults presents with multifaceted challenges: balancing the optimal complexity of antihyperglycemic medications prescribed, limited medication access due to socioeconomic status, medication nonadherence, and high prevalence of cardiometabolic comorbidities. This single-center, cross-sectional, retrospective chart analysis evaluated the association of Medication Regimen Complexity (MRC) with cardiometabolic outcomes (glycemic, atherogenic cholesterol, and blood pressure control) among non-Hispanic Black adults with type 2 diabetes. Utilizing 470 independent patient electronic health records, MRC and other covariates were examined to determine their associations with cardiometabolic outcomes. Chi-square tests of independence and multiple logistic regression were performed to identify associations between MRC and cardiometabolic outcomes. Our findings indicate significant negative and positive associations between MRC and glycemic control and atherogenic cholesterol control, respectively. However, there were no associations between MRC and blood pressure control. As diabetes MRC was shown to be associated with poor glycemic control and improved atherogenic cholesterol control, there is a critical need to standardize interdisciplinary diabetes care to include pharmacists and to develop more insurance policy interventions that increase access to newer, efficacious diabetes medications for historically marginalized populations.

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Medication Complexity among Disadvantaged African American Seniors in Los Angeles

Cited by 6 publications

References 41 publications

Multi-Dimensional Impact of Chronic Low Back Pain among Underserved African American and Latino Older Adults

Multi-Dimensional Impact of Chronic Low Back Pain among Underserved African American and Latino Older Adults

Factors Associated with Telehealth Utilization among Older African Americans in South Los Angeles during the COVID-19 Pandemic

Associations between Diabetes-Specific Medication Regimen Complexity and Cardiometabolic Outcomes among Underserved Non-Hispanic Black Adults Living with Type 2 Diabetes Mellitus

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