TY - JOUR
T1 - Association between patient-clinician relationships and adherence to antihypertensive medications among black adults
T2 - An observational study design
AU - Chang, Teng Jen
AU - Bridges, John F.P.
AU - Bynum, Mary
AU - Jackson, John W.
AU - Joseph, Joshua J.
AU - Fischer, Michael A.
AU - Lu, Bo
AU - Donneyong, Macarius M.
N1 - Publisher Copyright:
© 2021 The Authors.
PY - 2021/7/9
Y1 - 2021/7/9
N2 - BACKGROUND: We assessed the associations between patient-clinician relationships (communication and involvement in shared decision-making [SDM]) and adherence to antihypertensive medications. METHODS AND RESULTS: The 2010 to 2017 Medical Expenditure Panel Survey (MEPS) data were analyzed. A retrospective cohort study design was used to create a cohort of prevalent and new users of antihypertensive medications. We defined constructs of patient-clinician communication and involvement in SDM from patient responses to the standard question-naires about satisfaction and access to care during the first year of surveys. Verified self-reported medication refill information collected during the second year of surveys was used to calculate medication refill adherence; adherence was defined as medication refill adherence ≥80%. Survey-weighted multivariable-adjusted logistic regression models were used to measure the odds ratio (OR) and 95% CI for the association between both patient-clinician constructs and adherence. Our analysis involved 2571 Black adult patients with hypertension (mean age of 58 years; SD, 14 years) who were either persistent (n=1788) or new users (n=783) of antihypertensive medications. Forty-five percent (n=1145) and 43% (n=1016) of the sample reported having high levels of communication and involvement in SDM, respectively. High, versus low, patient-clinician communication (OR, 1.38; 95% CI, 1.14–1.67) and involvement in SDM (OR, 1.32; 95% CI, 1.08–1.61) were both associated with adherence to antihypertensives after adjusting for multiple covariates. These associations persisted among a subgroup of new users of antihypertensive medications. CONCLUSIONS: Patient-clinician communication and involvement in SDM are important predictors of optimal adherence to an-tihypertensive medication and should be targeted for improving adherence among Black adults with hypertension.
AB - BACKGROUND: We assessed the associations between patient-clinician relationships (communication and involvement in shared decision-making [SDM]) and adherence to antihypertensive medications. METHODS AND RESULTS: The 2010 to 2017 Medical Expenditure Panel Survey (MEPS) data were analyzed. A retrospective cohort study design was used to create a cohort of prevalent and new users of antihypertensive medications. We defined constructs of patient-clinician communication and involvement in SDM from patient responses to the standard question-naires about satisfaction and access to care during the first year of surveys. Verified self-reported medication refill information collected during the second year of surveys was used to calculate medication refill adherence; adherence was defined as medication refill adherence ≥80%. Survey-weighted multivariable-adjusted logistic regression models were used to measure the odds ratio (OR) and 95% CI for the association between both patient-clinician constructs and adherence. Our analysis involved 2571 Black adult patients with hypertension (mean age of 58 years; SD, 14 years) who were either persistent (n=1788) or new users (n=783) of antihypertensive medications. Forty-five percent (n=1145) and 43% (n=1016) of the sample reported having high levels of communication and involvement in SDM, respectively. High, versus low, patient-clinician communication (OR, 1.38; 95% CI, 1.14–1.67) and involvement in SDM (OR, 1.32; 95% CI, 1.08–1.61) were both associated with adherence to antihypertensives after adjusting for multiple covariates. These associations persisted among a subgroup of new users of antihypertensive medications. CONCLUSIONS: Patient-clinician communication and involvement in SDM are important predictors of optimal adherence to an-tihypertensive medication and should be targeted for improving adherence among Black adults with hypertension.
KW - Adherence
KW - Antihypertensive medication
KW - Black adults
KW - Communication
KW - Hypertension
KW - Patient-clinician relationships
KW - Shared decision-making
UR - http://www.scopus.com/inward/record.url?scp=85110886917&partnerID=8YFLogxK
U2 - 10.1161/JAHA.120.019943
DO - 10.1161/JAHA.120.019943
M3 - Article
C2 - 34238022
AN - SCOPUS:85110886917
SN - 2047-9980
VL - 10
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 14
M1 - e019943
ER -