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Pharmacotherapy. 2006 Apr;26(4):483-92.

Factors associated with drug adherence and blood pressure control in patients with hypertension.

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  • 1Department of Pharmacy Practice, Purdue University School of Pharmacy and Pharmacal Sciences, Indianapolis, Indiana, USA.

Abstract

STUDY OBJECTIVES:

To determine characteristics associated with drug adherence and blood pressure control among patients with hypertension, and to assess agreement between self-reported and refill adherences.

DESIGN:

Cross-sectional analysis of baseline data from an ongoing randomized controlled trial.

SETTING:

Primary care center at an urban, county health system in Indianapolis, Indiana.

PATIENTS:

Four hundred ninety-two participants with hypertension and taking at least one antihypertensive drug.

MEASUREMENTS AND MAIN RESULTS:

Social and demographic factors, comorbidity, self-reported drug adherence, prescription refill adherence, and systolic and diastolic blood pressures were recorded at baseline. Participants were aged 57 +/- 11 (mean +/- SD) years, were predominantly women (73%) and African-American (68%), and took 2.4 +/- 1.1 antihypertensive drugs. Agreement between self-reported and refill adherences was poor to fair (kappa = 0.21). On multiple logistic regression analysis, increased age (p< or =0.002) and being married (p=0.03) were independent predictors of improved self-reported and refill adherence, whereas depressed patients had low self-reported adherence (p=0.005), and African-Americans had low refill adherence (p<0.001). Compared with nonadherent patients, adherent patients had lower systolic (-5.4 mm Hg by self-report and -5.0 mm Hg by refill) and diastolic (-2.7 mm Hg by self-report and -3.0 mm Hg by refill) blood pressures (p< or =0.02). Increased age was the only other variable strongly associated with systolic and diastolic blood pressure control in both measures of drug adherence (p< or =0.001). The association of depression, race, and sex with blood pressure control was model dependent.

CONCLUSION:

Age, sex, race and depression are associated with antihypertensive drug adherence and blood pressure control. Self-reported and refill adherences appear to provide complementary information and are associated with reductions in systolic and diastolic blood pressure of similar magnitude.

PMID:
16553506
[PubMed - indexed for MEDLINE]
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