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

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.