Evidence map›Paper›PMID 28830861›Full record

Observational studyCirculation. Cardiovascular quality and outcomes2017

Addressing the Social Needs of Hypertensive Patients: The Role of Patient-Provider Communication as a Predictor of Medication Adherence.

Antoinette Schoenthaler, George J Knafl, Kevin Fiscella, Gbenga Ogedegbe

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Circulation. Cardiovascular quality and outcomes, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed, 4 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

46 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Antoinette SchoenthalerFrom the Division of Health and Behavior, Department of Population Health, Center for Healthful Behavior Change, New York University (A.S., G.O.); School of Nursing, University of North Carolina at Chapel Hill (G.J.K.); and Department of Family Medicine, University of Rochester School of Medicine and Dentistry, NY (K.F.). antoinette.schoenthaler@nyumc.org.
George J KnaflFrom the Division of Health and Behavior, Department of Population Health, Center for Healthful Behavior Change, New York University (A.S., G.O.); School of Nursing, University of North Carolina at Chapel Hill (G.J.K.); and Department of Family Medicine, University of Rochester School of Medicine and Dentistry, NY (K.F.).
Kevin FiscellaFrom the Division of Health and Behavior, Department of Population Health, Center for Healthful Behavior Change, New York University (A.S., G.O.); School of Nursing, University of North Carolina at Chapel Hill (G.J.K.); and Department of Family Medicine, University of Rochester School of Medicine and Dentistry, NY (K.F.).
Gbenga OgedegbeFrom the Division of Health and Behavior, Department of Population Health, Center for Healthful Behavior Change, New York University (A.S., G.O.); School of Nursing, University of North Carolina at Chapel Hill (G.J.K.); and Department of Family Medicine, University of Rochester School of Medicine and Dentistry, NY (K.F.).

Funding

Racial Differences in Patient-Provider Communication and Medication Adherence.K23HL098564 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI SCHOENTHALER, ANTOINETTE M · 2010 to 2014
$661k
NHLBI NIH HHS K23 HL098564
6 · The paper itself

Abstract

backgroundPoor medication adherence is a pervasive problem in patients with hypertension. Despite research documenting an association between patient-provider communication and medication adherence, there are no empirical data on how the informational and relational aspects of communication affect patient's actual medication-taking behaviors. The aim of this study was to evaluate the impact of patient-provider communication on medication adherence among a sample of primary care providers and their black and white hypertensive patients. METHODS AND

resultsCohort study included 92 hypertensive patients and 27 providers in 3 safety-net primary care practices in New York City. Patient-provider encounters were audiotaped at baseline and coded using the Medical Interaction Process System. Medication adherence data were collected continuously during the 3-month study with an electronic monitoring device. The majority of patients were black, 58% women, and most were seeing the same provider for at least 1 year. Approximately half of providers were white (56%), 67% women, and have been in practice for an average of 5.8 years. Fifty-eight percent of patients exhibited poor adherence to prescribed antihypertensive medications. Three categories of patient-provider communication predicted poor medication adherence: lower patient centeredness (odds ratio: 3.08; 95% confidence interval: 1.04-9.12), less discussion about patients' sociodemographic circumstances (living situation, relationship with partner; odds ratio: 6.03; 95% confidence interval: 2.15-17), and about their antihypertensive medications (odds ratio: 6.48; 95% confidence interval: 1.83-23.0). The effect of having less discussion about patients' sociodemographic circumstances on medication adherence was heightened in black patients (odds ratio: 8.01; 95% confidence interval: 2.80-22.9).

conclusionsThe odds of poor medication adherence are greater when patient-provider interactions are low in patient centeredness and do not address patients' sociodemographic circumstances or their medication regimen.

Indexed as

CommunicationEthnicityMedication AdherencePhysician-Patient RelationsAntihypertensive AgentsFemaleHumansHypertensionIncidenceMaleMiddle AgedPatient SatisfactionPrimary Health CareUnited StatesAntihypertensive Agentsantihypertensive agentshypertensionpatient-centered carepatient complianceprimary health care

Identifiers

PMID28830861
PMCPMC5571828

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.