Issues influencing medication adherence in Black women with hypertension

Abstract

<p>The purposes of this study were to: (a) describe the differences in adherent and nonadherent Black women who have hypertension (HTN), (b) examine issues that influence medication adherence, and (c) explore the relationship of reactant behaviors and medication adherence. Cox's interaction model of client health behavior was used to guide this study. Client singularity background variables: demographic characteristics (age and education), social influence (religion), previous health care experience (family history of HTN, comorbidities, number of medications, blood pressure [BP], and body mass index), and environmental resources (income and type of health coverage) along with client singularity dynamic variables: intrinsic motivation (reactance), cognitive appraisal (HTN knowledge, self-care of HTN, trust in health care provider, and coping), and affective response (perceived racism and depression) were examined to determine their influence on the health outcome, medication adherence. A cross-sectional, correlational non-experimental study was conducted with a convenience sample of 80 Black women who were taking antihypertensive prescription medications for blood pressure control. Over half of the participants (56%) were single, divorced, or widowed. Ages ranged from 19 to 60 with a mean age of 47.8 (SD &plusmn; 9.2). Almost one-third 30% (n=24) of the participants reported household incomes levels at or below the federal poverty level. The majority of the sample was employed (67%), physically inactive (90%), overweight/obese (88%), and had a history of smoking (54%). The study results did not show a difference between those who adhere to antihypertensive medications and those who do not. Also, there was no relationship between reactant behaviors and medication adherence. However, in the optimal predictive model, those aged 40-49 were less likely to be adherent to their antihypertensive medications. In contrast, those who took 5 to 7 medications were more likely to be adherent. Trust in the health care provider was highly associated with adherence to the medication treatment regimen. These results are congruent with the expectation that trust in the health care provider promotes better medication adherence. Future research should continue to identify factors that influence adherence to the treatment regimen among Black women with HTN and develop interventions that facilitate their ability to better manage their HTN and thus, maintain BP control.</p>