Defining Meaningful Change in Antihypertensive Medication Adherence in Adults with Established Hypertension: Implications for Clinical Practice

Erin Peacock; Paul Muntner; Leslie S Craig; Julia Silver; Katherine T Mills; Jing Chen; Lizheng Shi; Paul K Whelton; Jiang He; Marie Krousel-Wood

doi:10.1016/j.mcna.2023.06.008

Defining Meaningful Change in Antihypertensive Medication Adherence in Adults with Established Hypertension: Implications for Clinical Practice

Med Clin North Am. 2023 Nov;107(6S):e39-e52. doi: 10.1016/j.mcna.2023.06.008. Epub 2023 Jul 23.

Authors

Affiliations

¹ Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA; Center for Health Outcomes, Implementation, and Community-Engaged Science, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA. Electronic address: epeacoc@tulane.edu.
² Department of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35233, USA.
³ Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA.
⁴ Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, USA.
⁵ Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, USA.
⁶ Department of Health Policy and Management, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, USA.
⁷ Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA; Center for Health Outcomes, Implementation, and Community-Engaged Science, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, USA.

PMID: 38609280
DOI: 10.1016/j.mcna.2023.06.008

Abstract

Uncontrolled hypertension and low antihypertensive medication adherence remain significant clinical challenges. There is a critical need to detect meaningful change in adherence in clinical settings. The authors determined that a ≥2-point change in the 4-item Krousel-Wood Medication Adherence Scale score represents meaningful change in antihypertensive medication adherence. Among a sample of participants in an ongoing clinical trial, 5.9% experienced a decline in adherence, which was associated with higher blood pressure (BP) and a higher prevalence of uncontrolled BP at 6 months. Meaningful change in medication adherence behavior may be key in managing hypertension to improve BP control and health outcomes.

Keywords: Hypertension; Medication adherence; Sex differences; Test-retest reliability.

Publication types

Review

MeSH terms

Adult
Antihypertensive Agents* / therapeutic use
Humans
Hypertension* / drug therapy
Hypertension* / epidemiology
Medication Adherence

Substances

Antihypertensive Agents

Grants and funding

K12 AR084224/AR/NIAMS NIH HHS/United States