Provider communication effects medication adherence in hypertensive African Americans

被引:127
作者
Schoenthaler, Antoinette [1 ]
Chaplin, William F. [2 ]
Allegrante, John P. [3 ,4 ]
Fernandez, Senaida
Diaz-Gloster, Marleny
Tobin, Jonathan N. [5 ]
Ogedegbe, Gbenga
机构
[1] NYU, Sch Med, Dept Med, Div Gen Internal Med, New York, NY 10010 USA
[2] St Johns Univ, Dept Psychol, New York, NY USA
[3] Columbia Univ, Teachers Coll, Dept Hlth & Behav Studies, New York, NY 10027 USA
[4] Columbia Univ, Mailman Sch Publ Hlth, Dept Sociomed Sci, New York, NY 10027 USA
[5] Yeshiva Univ, Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, New York, NY 10033 USA
关键词
Patient-provider communication; Medication adherence; African American; Hypertension; PARTICIPATORY DECISION-MAKING; RELATIONSHIP-CENTERED CARE; BLOOD-PRESSURE; PHYSICIAN COMMUNICATION; PATIENT COMMUNICATION; HEALTH OUTCOMES; STYLE; CONCORDANCE; DEPRESSION; VALIDITY;
D O I
10.1016/j.pec.2008.09.018
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective: To evaluate the effect of patients' perceptions of providers' communication on medication adherence in hypertensive African Americans. Methods: Cross-sectional study of 439 patients with poorly controlled hypertension followed in community-based healthcare practices in the New York metropolitan area. Patients' rating of their providers' communication was assessed with a perceived communication style questionnaire,while medication adherence was assessed with the Morisky self-report measure. Results: Majority of participants were female, low-income, and had high school level educations, with mean age of 58 years. Fifty-five percent reported being nonadherent with their medications; and 51% rated their provider's communication to be non-collaborative. In multivariate analysis adjusted for patient demographics and covariates (depressive symptoms, provider degree), communication rated as collaborative was associated with better medication adherence (beta = -.11, p = .03). Other significant correlates of medication adherence independent of perceived communication were age (beta = .13, p and depressive symptoms (beta = -.18, p = .001), Conclusion: Provider communication rated as more collaborative was associated with better adherence to antihypertensive medications in a sample of low-income hypertensive African-American patients. Practice implications: The quality of patient-provider communication is a potentially modifiable element of the medical relationship that may affect health outcomes in this high-risk patient population. Published by Elsevier Ireland Ltd.
引用
收藏
页码:185 / 191
页数:7
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