A longitudinal study of adherence to medication in black men with hypertension

黑人高血压患者服药依从性的纵向研究

• 批准号: 8399331
• 负责人: Lisa M Lewis
• 金额: $ 49.53万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8399331
• 关键词: 18 year old; Accounting; Address; Adherence; Antihypertensive Agents; Blood Pressure; Caring; Cessation of life; Communities; Correlation Studies; Death Rate; Development; Electronics; Ethnic group; Gold; Health Care Seeking Behavior; Health Promotion; Health Services Accessibility; High Prevalence; Hypertension; Income; Intervention; Interview; Literature; Longitudinal Studies; Measures; Mental Depression; Metric; Minority Groups; Monitor; Outcome; Patient Self-Report; Patients; Pattern; Perception; Pharmaceutical Preparations; Pharmacotherapy; Physicians; Population; Primary Health Care; Prospective Studies; Psychosocial Factor; Race; Recruitment Activity; Research; Research Project Grants; Role; Schedule; Self Efficacy; Self Medication; Social Network; Statistical Models; Time; Trust; Tweens; United States; Ursidae Family; base; blood pressure regulation; high risk; improved; male; medication compliance; men; minority health; novel strategies; primary care setting; primary outcome; response; secondary outcome; social

DESCRIPTION (provided by applicant): Black men in the United States bear a disproportionate burden of uncontrolled hypertension (HTN) when compared to other racial and ethnic groups. Black men are more likely to have HTN when compared to white men and their death rates from HTN are more than double those of white men. Effective antihypertensive medications are available to treat HTN but the rate of medication adherence is unacceptably low in black men. Previous studies of medication adherence in hypertensive blacks are limited in that they are cross-sectional and used self-report measures of adherence. The overall objective of this longitudinal study is to determine factors that are associated with poor medication adherence in black men with HTN. The factors to be investigated include self-efficacy, social networks, depression, physician trust, and masculinity. We propose to conduct a prospective study with 200 black men > 18 years with HTN and taking at least one antihypertensive medication followed in urban community-based primary care settings. Patients will be followed for 1 year. The primary outcome, medication adherence will be assessed with electronic monitoring and every 3 months post- baseline. Self-efficacy, social networks, depression, physician trust, and masculinity will be assessed using validated measures with face-to-face interviews every 3 months including at baseline. A secondary objective is to assess the impact of medication adherence on blood pressure. Results of this study will identify modifiable factors of adherence and lay the groundwork for tailored interventions to improve medication adherence among hypertensive black men. PUBLIC HEALTH RELEVANCE: This research project seeks to examine the longitudinal relationship between psychosocial variables including masculinity, social networks, physician trust, depression, self efficacy and medication adherence in hypertensive black men. Findings from the proposed study will add significantly to the literature in terms of modifiable factors tha impede medication adherence in hypertensive black men. Such information would be critical in the development of tailored interventions targeted at improving BP control in this high-risk population.

描述（由申请人提供）：与其他种族和族裔群体相比，美国的黑人承担不受控制的高血压（HTN）负担不成比例。与白人相比，黑人更有可能拥有HTN，而HTN的死亡率是白人的两倍以上。有效的降压药可用于治疗HTN，但黑人的药物依从性率不足。先前关于高血压黑人药物依从性的研究受到限制，因为它们是横断面的，并且使用了依从性的自我报告措施。这项纵向研究的总体目的是确定与黑人HTN的药物依从性差有关的因素。要调查的因素包括自我效能感，社交网络，抑郁，医师信任和男性气质。我们建议对200年的HTN进行一项前瞻性研究，并在HTN中> 18岁，并在基于城市社区的初级保健环境中服用至少一种降压药。患者将遵循1年。主要结果，将通过电子监测和基线后每3个月评估药物依从性。自我效能感，社交网络，抑郁症，医师信任和男性气质将通过经过验证的措施进行评估，每3个月，包括基线，包括面对面的访谈。次要目标是评估药物依从性对血压的影响。这项研究的结果将确定可修改的依从性因素，并为量身定制的干预措施奠定基础，以改善高血压黑人的药物依从性。 公共卫生相关性：该研究项目旨在研究心理社会变量，包括男性化，社交网络，医师信任，抑郁，自我效能和药物遵守的社会心理变量之间的纵向关系。拟议的研究的发现将大大增加文献的可修改因素，从而阻碍了高血压黑人的药物依从性。此类信息对于针对这种高风险人群的针对改善BP控制的量身定制干预措施的制定至关重要。