Beyond Medication Adherence: The Role of Patients' Beliefs and Life Context in Blood Pressure Control

Ethn Dis. 2019 Oct 17;29(4):567-576. doi: 10.18865/ed.29.4.567. eCollection 2019 Fall.

Abstract

Objective: 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; 93 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.

Practical 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.

Keywords: Health Beliefs; Hypertension; Life Context; Medication Adherence; Survey Methods.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure
  • Cross-Sectional Studies
  • Female
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / physiopathology*
  • Life Style
  • Male
  • Medication Adherence
  • Middle Aged
  • Surveys and Questionnaires

Substances

  • Antihypertensive Agents