Association of Perceived Stress and Discrimination on Medication Adherence among Diverse Patients with Uncontrolled Hypertension
| Autor: | Nadia Andrade, Anika L Hines, Carmen Alvarez, Jill A. Marsteller, Lisa A. Cooper, Kathryn A. Carson, Chidinma A. Ibe |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Epidemiology Original Report: Stigma Discrimination Health Disparities Collaborative Care Blood Pressure Disease Logistic regression Medication Adherence Odds 03 medical and health sciences Health care Humans Medicine Social determinants of health Antihypertensive Agents Social stress 030505 public health business.industry General Medicine Middle Aged United States Cross-Sectional Studies Blood pressure Hypertension Female 0305 other medical science business Stress Psychological Demography |
| Zdroj: | Ethn Dis |
| ISSN: | 1945-0826 1049-510X |
| Popis: | Background: Uncontrolled hypertension is a significant risk factor for cardiovascular morbidity and mortality. In the United States, many patients remain uncontrolled, in part, due to poor medication adherence. Efforts to improve hypertension control include not only attending to medical management of the disease but also the social determinants of health, which impact medication adherence, and ultimately blood pressure control.Purpose: To determine which social determinants – health care access or community and social stressors - explain medication adherence.Methods: In this cross-sectional analysis, we used baseline data (N=1820, collected August 2017 to October 2019) from a pragmatic trial, which compares the effectiveness of a multi-level intervention including collaborative care and a stepped approach with enhanced standard of care for improving blood pressure. We used logistic regression analyses to examine the association between patient experiences of care and community and social stressors with medication adherence.Results: The participants represented a diverse sample: mean age of 60 years; 59% female; 57.3% Black, 9.6% Hispanic, and 33.2% White. All participants had a blood pressure reading ≥140/90 mm Hg (mean blood pressure – 152/85 mm Hg). Half of the participants reported some level of non-adherence to medication. Regression analysis showed that, compared with Whites, Blacks (AOR .47; 95% CIs: .37-.60, P |
| Databáze: | OpenAIRE |
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