250353 Patients' change from medication noncompliance to compliance in the Georgia Stroke & Heart Attack Prevention Program

Tuesday, November 1, 2011: 1:30 PM

Marylen Rimando, PhD, MPH, CHES, CPH , Department of Health and Human Physiology, University of Iowa, Iowa City, IA
Introduction: Hypertension is an important clinical issue in practice for physicians today. African Americans report higher rates of noncompliance than Whites based upon previous studies. Hypertension, known as a silent killer, affects more than 73 million Americans or approximately 1 in 3 adults in their lifetime. African Americans have been shown to have higher rates of uncontrolled hypertension compared to Caucasians. Also, African Americans have higher mortality rates than Caucasians. The Stroke and Heart Attack Prevention Program (SHAPP) is an ongoing hypertension management program for mostly low-income, uninsured patients in Georgia. The purpose is to understand the patients' experiences and attitudes about their hypertension management. Methods: The conceptual framework was phenomenology. Twenty eight African American patients were interviewed individually at a hypertension clinic in a health department in the southeast. Patients were interviewed following their clinic visit with the nurse in the health department. Patients were diagnosed with hypertension and enrolled in the SHAPP program for at least a year. The researcher conducted the semi-structured interviews and tape recorded each interview. Interview transcripts were analyzed by the researcher to identify emergent themes in patients' experiences as a whole. Results: Since the beginning of their participation in the SHAPP program, all but one patient changed from noncompliant to compliant with their hypertension medications. The patients believed that the medications contributed to their decrease in blood pressure and ability to manage their hypertension. Patients reported higher self-efficacy to control their hypertension increased as they came to the clinic for their biannual checkups. Discussion: These results can be especially helpful to primary care physicians who encounter hypertensive patients and African Americans in their practice. Limitations include the inability to generalize to all patients diagnosed with hypertension and those living in other regions of the US and other countries. Also, this study suggests the importance of individual patient education in hypertension management and compliance. Future patient education programs should be funded to assist primary care physicians who encounter noncompliance in their practice.

Learning Areas:
Advocacy for health and health education
Basic medical science applied in public health
Chronic disease management and prevention
Clinical medicine applied in public health
Conduct evaluation related to programs, research, and other areas of practice

Learning Objectives:
1. Explain the patients' change from noncompliance to compliance with their hypertensive medications.

Keywords: Hypertension, African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted this work for my doctoral dissertation at the University of Georgia.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.