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

Andrew B. Morris, Jingjin Li, Kurt Kroenke, Tina E. Bruner-England, Jim M. Young, Michael Murray

Research output: Contribution to journalArticle

108 Citations (Scopus)

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 (κ = 0.21). On multiple logistic regression analysis, increased age (p≤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≤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≤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.

Original languageEnglish
Pages (from-to)483-492
Number of pages10
JournalPharmacotherapy
Volume26
Issue number4
DOIs
StatePublished - Apr 2006

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Blood Pressure
Hypertension
Pharmaceutical Preparations
Antihypertensive Agents
African Americans
Self Report
Urban Health
Drug Prescriptions
Comorbidity
Primary Health Care
Randomized Controlled Trials
Cross-Sectional Studies
Logistic Models
Regression Analysis
Demography

Keywords

  • Compliance
  • Drug adherence
  • Hypertension
  • Persistence

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Factors associated with drug adherence and blood pressure control in patients with hypertension. / Morris, Andrew B.; Li, Jingjin; Kroenke, Kurt; Bruner-England, Tina E.; Young, Jim M.; Murray, Michael.

In: Pharmacotherapy, Vol. 26, No. 4, 04.2006, p. 483-492.

Research output: Contribution to journalArticle

Morris, Andrew B. ; Li, Jingjin ; Kroenke, Kurt ; Bruner-England, Tina E. ; Young, Jim M. ; Murray, Michael. / Factors associated with drug adherence and blood pressure control in patients with hypertension. In: Pharmacotherapy. 2006 ; Vol. 26, No. 4. pp. 483-492.
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