BEYOND MEDICATION ADHERENCE: THE ROLE OF PATIENTS' BELIEFS AND LIFE CONTEXT IN BLOOD PRESSURE CONTROL

被引:5
作者
Kressin, Nancy R. [1 ,2 ,3 ]
Elwy, A. Rani [1 ,2 ,4 ]
Glickman, Mark [1 ,2 ,5 ]
Orner, Michelle B. [1 ,2 ]
Fix, Gemmae M. [1 ,2 ,6 ]
Borzecki, Ann M. [1 ,2 ,3 ,6 ]
Katz, Lois A. [7 ,8 ]
Cortes, Dharma E. [9 ,10 ]
Cohn, Ellen S. [11 ]
Barker, Anna [1 ,2 ]
Bokhour, Barbara G. [1 ,2 ,6 ]
机构
[1] VA Boston Healthcare Syst, CHOIR, VA HSR & Ctr Innovat, Bedford, MA USA
[2] Edith Nourse Rogers Mem Vet Hosp, Bedford, MA USA
[3] Boston Univ, Sch Med, Sect Gen Internal Med, Boston, MA 02118 USA
[4] Brown Univ, Dept Psychiat & Human Behav, Warren Alpert Med Sch, Providence, RI 02912 USA
[5] Harvard Univ, Dept Stat, Boston, MA 02115 USA
[6] Boston Univ, Sch Publ Hlth, Boston, MA USA
[7] VA New York Harbor Healthcare Syst, New York, NY USA
[8] NYU, Sch Med, New York, NY USA
[9] Cambridge Hlth Alliance, Cambridge, MA USA
[10] Harvard Med Sch, Cambridge, MA USA
[11] Boston Univ, Sargent Coll Hlth & Rehabil Sci, Boston, MA 02215 USA
关键词
Hypertension; Medication Adherence; Survey Methods; Health Beliefs; Life Context; ANTIHYPERTENSIVE MEDICATION; CARE; HYPERTENSION; MANAGEMENT; INTERVENTION; DISPARITIES; PREVENTION; EXPERIENCE; PROGRAM; ILLNESS;
D O I
10.18865/ed.29.4.567
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objectives: Despite numerous interventions to address adherence to antihypertensive medications, continued high rates of uncontrolled blood pressure (BP) suggest a need to better understand patient factors beyond adherence associated with BP control. We examined how patients' BP-related beliefs, and aspects of life context affect BP control, beyond medication adherence. Methods: We conducted a cross-sectional telephone survey of primary care patients with hypertension between 2010 and 2011 (N=103; 9:3 had complete data on all variables and were included in the regression analyses). We assessed patient sociodemographics (including race/ethnicity), medication adherence, BP-related beliefs, aspects of life context, and used clinical BP assessments. Results: Regression models including sociodemographics, medication adherence, and either beliefs or context consistently predicted BP control. Adding context after beliefs added no predictive value while adding beliefs after context significantly predicted BP control. Conclusion: Including patients' BP beliefs after context had the strongest effects on BP control. Practice Implications: Results suggest that when clinicians must choose a dimension on which to intervene, focusing on beliefs would be the most fruitful approach to effecting change in BP control.
引用
收藏
页码:567 / 576
页数:10
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