Relationship of Blood Pressure Self-Monitoring, Medication Adherence, Self-Efficacy, Stage of Change, and Blood Pressure Control among Municipal Workers with Hypertension

Q: What are the key findings of this study?

Medication adherence self-efficacy was strongly correlated with medication adherence (r = 0.549, p < 0.001) among hypertensive municipal workers, though neither predicted blood pressure control.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=149). Intervention: Stage of change, medication adherence, medication adherence self-efficacy, and blood pressure self-monitoring. Primary outcome: Blood pressure control (<140/90 mmHg) and medication adherence relationships (r = 0.549, p=<0.001).

Q: What does this research mean for the field?

Medication adherence self-efficacy strongly correlates with medication adherence among hypertensive municipal workers, but neither self-efficacy, stage of change, nor adherence predicts blood pressure control. Novelty: ClaimNovelty.CONTRADICTORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To determine the relationship among blood pressure self-monitoring, medication adherence, self-efficacy, stage of change, and blood pressure control among municipal workers with hypertension.

Tonya L. Breaux-Shropshire; Kathleen C. Brown; Erica R. Pryor; Elizabeth H. Maples

doi:10.1177/216507991206000704

July 1, 2012Workplace Health & SafetyOpen Access

Relationship of Blood Pressure Self-Monitoring, Medication Adherence, Self-Efficacy, Stage of Change, and Blood Pressure Control among Municipal Workers with Hypertension

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Key result

Medication adherence self-efficacy correlates with adherence but fails to predict blood pressure control.

r = 0.549
P<0.001
n=149

Why the study?

Do stage of change, medication adherence, medication adherence self-efficacy, and blood pressure self-monitoring predict blood pressure control among municipal workers with treated hypertension?

Key Points

To determine the relationship among blood pressure self-monitoring, medication adherence, self-efficacy, stage of change, and blood pressure control among municipal workers with hypertension.
Evaluated 149 municipal workers who met inclusion criteria out of more than 700 screened, of whom 85% were male, 69% were Black, and the average age was 47 years (SD = 8.4).
Assessed medication adherence, medication adherence self-efficacy, stage of change, and self-monitoring of blood pressure in home and community settings.
Used correlation and regression analyses to determine predictors of blood pressure self-monitoring and blood pressure control.
Medication adherence was strongly and positively associated with medication adherence self-efficacy (r = .549, p < .05).
Stage of change was a significant independent predictor of blood pressure self-monitoring, but was not associated with blood pressure control (p = .35).
No variables were significant univariate predictors of blood pressure control, including medication adherence self-efficacy (χ2 = 4.509, df = 2, p = .092) and blood pressure self-monitoring.

Study Design

Type

Cross-Sectional (n=149)

Structured PICO

Do stage of change, medication adherence, medication adherence self-efficacy, and blood pressure self-monitoring predict blood pressure control among municipal workers with treated hypertension?

P

Population

149 municipal workers with treated hypertension and access to health insurance (mean age 47 years, 85% male, 69% Black) evaluated in a cross-sectional employee wellness program study.

E

Exposure

Psychosocial and behavioral factors: stage of change (Transtheoretical Model), medication adherence (8-item Morisky Medication Adherence Scale), medication adherence self-efficacy (MASES-R), and blood pressure self-monitoring

O

Outcome

Blood pressure control (defined as <140/90 mmHg per JNC 7 guidelines, measured as the average of two electronic readings taken 3 minutes apart after 5 minutes of rest) and self-monitoring of blood pressuresurrogate

Main Result

Effect estimate: r = 0.549

p-value: p=<0.001

Among hypertensive municipal employees, stage of change predicts blood pressure self-monitoring and self-efficacy strongly correlates with medication adherence, highlighting targets for tailored occupational health nursing interventions even though direct prediction of blood pressure control was not observed in this small cohort.

Limitations

Small sample size (n = 149) and relatively homogeneous participant group lacking variability in key measures
Convenience sample of volunteers from an employee wellness program
Use of self-report instruments subject to socially desirable answers and recall bias
Cross-sectional correlational design cannot demonstrate causation
Small sample size (n = 149) and relatively homogeneous sample lacking variability
Convenience sampling of volunteers
Self-report instruments subject to social desirability and recall bias
Correlational cross-sectional design cannot establish causation

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Implication

Adherence self-efficacy correlates with medication-taking but neither predicts control; leaves open whether targeting self-efficacy improves outcomes in hypertensive workers.

Abstract

Uncontrolled blood pressure remains a major public health issue. Medication adherence is a key factor in blood pressure management; however, adherence behavior is not clearly understood and the most significant factors contributing to poor medication adherence and blood pressure control are unknown. The purpose of this study was to determine the relationship of self-monitoring of blood pressure, medication adherence, self-efficacy, stage of change, and blood pressure control among municipal workers with access to health insurance. Stage of change was a significant independent predictor of self-monitoring of blood pressure, but not blood pressure control. A strong relationship was found between medication adherence and medication adherence self-efficacy ( r = .549, p < .05).

Discussion

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Cite This Study

Breaux-Shropshire et al. (2012) conducted a cross-sectional in Hypertension (n=149). Stage of change, medication adherence, medication adherence self-efficacy, and blood pressure self-monitoring was evaluated on Blood pressure control (<140/90 mmHg) and medication adherence relationships (r = 0.549, p=<0.001). Medication adherence self-efficacy was strongly correlated with medication adherence (r = 0.549, p < 0.001) among hypertensive municipal workers, though neither predicted blood pressure control.

synapsesocial.com/papers/6a5ebcbf62bcfcedb9633302 https://doi.org/10.1177/216507991206000704

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Relationship of Blood Pressure Self-Monitoring, Medication Adherence, Self-Efficacy, Stage of Change, and Blood Pressure Control among Municipal Workers with Hypertension

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Relationship of Blood Pressure Self-Monitoring, Medication Adherence, Self-Efficacy, Stage of Change, and Blood Pressure Control among Municipal Workers with Hypertension

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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