Factors associated with non-adherence to three hypertension self-management behaviors: preliminary data for a new instrument.
| dc.contributor.author | Crowley, Matthew J | |
| dc.contributor.author | Grubber, Janet M | |
| dc.contributor.author | Olsen, Maren K | |
| dc.contributor.author | Bosworth, Hayden B | |
| dc.date.accessioned | 2024-02-01T16:37:27Z | |
| dc.date.available | 2024-02-01T16:37:27Z | |
| dc.date.issued | 2013-01 | |
| dc.description.abstract | BackgroundClinicians have difficulty in identifying patients that are unlikely to adhere to hypertension self-management. Identifying non-adherence is essential to addressing suboptimal blood pressure control and high costs.Objectives1) To identify risk factors associated with non-adherence to three key self-management behaviors in patients with hypertension: proper medication use, diet, and exercise; 2) To evaluate the extent to which an instrument designed to identify the number of risk factors present for non-adherence to each of the three hypertension self-management behaviors would be associated with self-management non-adherence and blood pressure.DesignCross-sectional analysis of randomized trial data.PatientsSix hundred and thirty-six primary care patients with hypertension.Measurements1) Demographic, socioeconomic, psychosocial, and health belief-related factors; 2) measures of self-reported adherence to recommended medication use, diet recommendations, and exercise recommendations, all collected at baseline assessment; 3) systolic blood pressure (SBP) and diastolic blood pressure (DBP).ResultsWe identified patient factors associated with measures of non-adherence to medications, diet, and exercise in hypertension. We then combined risk factors associated with ≥1 adherence measure into an instrument that generated three composite variables (medication, diet, and exercise composites), reflecting the number of risk factors present for non-adherence to the corresponding self-management behavior. These composite variables identified subgroups with higher likelihood of medication non-adherence, difficulty following diet recommendations, and difficulty following exercise recommendations. Composite variable levels representing the highest number of self-management non-adherence risk factors were associated with higher SBP and DBP.ConclusionsWe identified factors associated with measures of non-adherence to recommended medication use, diet, and exercise in hypertension. We then developed an instrument that was associated with non-adherence to these self-management behaviors, as well as with blood pressure. With further study, this instrument has potential to improve identification of non-adherent patients with hypertension. | |
| dc.identifier.issn | 0884-8734 | |
| dc.identifier.issn | 1525-1497 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | Springer Science and Business Media LLC | |
| dc.relation.ispartof | Journal of general internal medicine | |
| dc.relation.isversionof | 10.1007/s11606-012-2195-1 | |
| dc.rights.uri | ||
| dc.subject | Humans | |
| dc.subject | Hypertension | |
| dc.subject | Antihypertensive Agents | |
| dc.subject | Blood Pressure Monitoring, Ambulatory | |
| dc.subject | Combined Modality Therapy | |
| dc.subject | Exercise | |
| dc.subject | Self Care | |
| dc.subject | Diet | |
| dc.subject | Risk Factors | |
| dc.subject | Cross-Sectional Studies | |
| dc.subject | Attitude to Health | |
| dc.subject | Health Behavior | |
| dc.subject | Patient Compliance | |
| dc.subject | Psychometrics | |
| dc.subject | Blood Pressure | |
| dc.subject | Socioeconomic Factors | |
| dc.subject | Aged | |
| dc.subject | Middle Aged | |
| dc.subject | Primary Health Care | |
| dc.subject | North Carolina | |
| dc.subject | Female | |
| dc.subject | Male | |
| dc.subject | Medication Adherence | |
| dc.title | Factors associated with non-adherence to three hypertension self-management behaviors: preliminary data for a new instrument. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Crowley, Matthew J|0000-0002-6205-4536 | |
| duke.contributor.orcid | Olsen, Maren K|0000-0002-9540-2103 | |
| duke.contributor.orcid | Bosworth, Hayden B|0000-0001-6188-9825 | |
| pubs.begin-page | 99 | |
| pubs.end-page | 106 | |
| pubs.issue | 1 | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | School of Medicine | |
| pubs.organisational-group | Basic Science Departments | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Institutes and Centers | |
| pubs.organisational-group | Biostatistics & Bioinformatics | |
| pubs.organisational-group | Medicine | |
| pubs.organisational-group | Psychiatry & Behavioral Sciences | |
| pubs.organisational-group | Medicine, Endocrinology, Metabolism, and Nutrition | |
| pubs.organisational-group | Medicine, General Internal Medicine | |
| pubs.organisational-group | Duke Cancer Institute | |
| pubs.organisational-group | Duke Clinical Research Institute | |
| pubs.organisational-group | Institutes and Provost's Academic Units | |
| pubs.organisational-group | Center for the Study of Aging and Human Development | |
| pubs.organisational-group | Initiatives | |
| pubs.organisational-group | Duke Science & Society | |
| pubs.organisational-group | Population Health Sciences | |
| pubs.organisational-group | Duke Innovation & Entrepreneurship | |
| pubs.organisational-group | Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences | |
| pubs.organisational-group | Duke - Margolis Center For Health Policy | |
| pubs.organisational-group | Biostatistics & Bioinformatics, Division of Biostatistics | |
| pubs.publication-status | Published | |
| pubs.volume | 28 |