What is the clinical evidence from this study?

Study design: Cohort. Population: hypertension (n=1544). Primary outcome: variance in pharmacy refill and self-reported adherence explained by traditional barriers.

What question did this study set out to answer?

To evaluate how well traditional barriers explain antihypertensive medication adherence in older adults and propose an expanded framework incorporating cognitive and structural factors.

March 5, 2021American Journal of HypertensionOpen Access

Medication Adherence: Expanding the Conceptual Framework

Q: What are the key findings of this study?

Traditional barriers to antihypertensive medication adherence explained only 6.4% and 14.8% of the variance in pharmacy refill and self-reported adherence, respectively, among older adults.

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Key result

Traditional barriers explain at most ~15% of variance in antihypertensive adherence among older adults.

n=1,544

Why the study?

Translation of interventions targeting traditional barriers to antihypertensive medication adherence into population-level improvements among older adults remains suboptimal.

Population

1,544 older adults with established hypertension

Design

Cohort study

Authors

MKMarie Krousel‐WoodPreventive Cardiology LCLeslie S. CraigTulane University EPErin PeacockTulane University

Discussion

Member takes

Implication

Limited explanatory power of traditional barriers warrants caution in adherence programs; leaves open roles of implicit attitudes and structural determinants.

Key Points

To evaluate how well traditional barriers explain antihypertensive medication adherence in older adults and propose an expanded framework incorporating cognitive and structural factors.
Analyzed older adults with established hypertension from the Cohort Study of Medication Adherence among Older adults (CoSMO; N = 1,544; mean age = 76.2 years, 59.5% women, 27.9% Black).
Assessed medication adherence through pharmacy refills via proportion of days covered (PDC <0.80) and self-report via the 4-item Krousel-Wood Medication Adherence Scale (K-Wood-MAS-4 ≥1).
Low adherence was present in 24.1% of participants by pharmacy refill (PDC <0.80) and in 38.9% by self-report (K-Wood-MAS-4 ≥1).
Traditional adherence barriers accounted for only 6.4% of the variance in pharmacy refill adherence and 14.8% of the variance in self-reported adherence.

Study Design

Type

Cohort (n=1,544)

Structured PICO

Population

1,544 older adults with established hypertension from the Cohort Study of Medication Adherence among Older adults (CoSMO), mean age 76.2 years, 59.5% women, 27.9% Black.

Outcome

Variance in pharmacy refill (proportion of days covered) and self-reported adherence (4-item Krousel-Wood Medication Adherence Scale) explained by traditional barriers.patient reported

Traditional barriers explain only a small fraction of medication adherence variance in older adults with hypertension, highlighting the need to consider implicit attitudes, time preferences, and structural social determinants of health.

Cite This Study

Krousel‐Wood et al. (2021) conducted a cohort in hypertension (n=1,544). Traditional barriers to antihypertensive medication adherence explained only 6.4% and 14.8% of the variance in pharmacy refill and self-reported adherence, respectively, among older adults.

synapsesocial.com/papers/6a10d962f85e2d3f759f684c https://doi.org/10.1093/ajh/hpab046

Topics

Hypertension management

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Implication

Limited explanatory power of traditional barriers warrants caution in adherence programs; leaves open roles of implicit attitudes and structural determinants.

Medication Adherence: Expanding the Conceptual Framework

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Medication Adherence: Expanding the Conceptual Framework

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider