Intentional Non-Adherence with High Blood Pressure Care Among Middle Aged Korean Americans

Poster Presentation

Friday, 21 July 2006
10:00 AM - 10:30 AM
Friday, 21 July 2006
3:00 PM - 3:30 PM

This presentation is part of : Poster Presentations III

Eun-Young Kim, PhD, MPH, RN, Hae-Ra Han, RN, PhD, Seonghee Jeong, PhD, RN, Hyunjeong Park, RN, MPH, CRNP, and Miyong T. Kim, RN, PhD. School of Nursing, The Johns Hopkins University, Baltimore, MD, USA

Learning Objective #1: Develop an intervention to reduce the intentional non-adherence to antihypertensive medications
Learning Objective #2: Discuss predictors of intentional and unintentional non-adherence to antihypertensive medication regimens

While poor adherence level to high blood pressure (HBP) treatment recommendations is a major concern across many health care sectors, our understanding about the complex phenomenon is still limited. The purpose of this paper is to conduct an in-depth investigation of adherence to HBP treatment recommendation by further distinguishing the concept by intentional non-adherence (missing to fit one’s needs) and unintentional non-adherence (forgetting to take medication) using a group of Korean Americans (KA) with HBP. Specifically, we examine the predictors of intentional and unintentional non-adherence to antihypertensive medication regimens and their relationships and magnitudes to ultimate BP outcomes.

The data for this analysis was obtained from baseline data of an ongoing HBP intervention trial. A total of 401 KA with HBP was enrolled in the trial, 187 of who were on hypertensive medication were included in this analysis. Theoretically selected variables for this analysis are following: demographic and clinical variables, knowledge, belief, and self-efficacy regarding HBP, satisfaction with care.

Approximately 27.3% of the subjects reported intentional non-adherence while 28.9% reported unintentional non-adherence. After controlling for demographic variables, multivariate analysis revealed that a greater number of adverse effects (Adjusted OR 1.20 : 95% CI, 1.01 to 1.35), a lesser number of co-morbid conditions(Adjusted OR 0.51 : 95% CI, 0.27 to 0.97), and a lower level of HBP knowledge(Adjusted OR 0.89 : 95% CI, 0.79 to 0.99) were significantly associated with intentional non-adherence. Unintentional non-adherence was less strongly associated with all variables.

This results indicate that non-adherence to antihypertensive medication is prevalent among hypertensive KA. The results of this study also highlight the need of an intervention that focuses on increasing patient knowledge about HBP including benefit, side effect or unpleasant symptoms of HBP medication as it will reduce the intentional non-adherence to antihypertensive medications and ultimately helpful in achieving adequate BP control.

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