Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #112016

Donald Morisky, ScD¹, Alfonso Ang, PhD¹, Harry J. Ward, MD², and Marie Krousel-Wood, MD, MSPH³. (1) Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, 650 Charles E. Young Drive South, CHS 26-070, Los Angeles, CA 90095-1772, 310-825-8508, dmorisky@ucla.edu, (2) Internal Medicine, Charles Drew School of Medicine, King/Drew Medical Center, 12021 South Wilmington Ave., Los Angeles, CA 90059, (3) Department of Epidemiology and Department of Family and Community Medicine, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121

Non-adherence to anti-hypertensive treatment medication is a major reason for poor control of hypertension worldwide, and promoting adherence is a major clinical hurdle that is necessary to decrease cardiovascular mortality. This study examines medication adherence among 1,367 African American (75%) and Hispanic American (25%) patients recruited during regularly scheduled appointments at a large medical center as part of a four-year community clinical trial. An 8-item medication adherence scale that can be easily administered and is diagnostic in nature was developed for the study. The eight-item medication adherence scale was found to have a reliability of 0.83. By using receiver operating characteristic (ROC) curve analysis, the sensitivity of the measure estimated to be 83%, and the specificity was 70%. The medication adherence measure was found to have good concurrent and predictive validity. A total of 74% of individuals scoring high on the adherence measure had their blood pressure under control compared to 48% of individuals scoring low (p < 0.001). For patients who are non-adherent, the proper corrective measures were implemented, such as education of the patient regarding hypertension care, correcting misunderstandings and incorrect beliefs concerning hypertension treatment, reducing stress and improving coping skills among patients, or establishing a regimen to foster medication adherence. These results indicate that health care providers can significantly influence adherence behaviors of their patients. Health care providers can support and reinforce current positive behaviors or clarify misunderstandings and incorrect beliefs.

Learning Objectives: At the conclusion of the session, participants will be able to

• acquire knowledge regarding practical, as well statistical methods to develop measures to assess patient adherence.
• Describe the study design and components needed to obtain a reliable and valid method of assessing patient adherence,
• Identify patient and provider-related factors that enhance medication-taking behavior.

Keywords: Adherence, Hypertension

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.