Co-occurring reasons for medication nonadherence within subgroups of patients with hyperlipidemia.
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2019-04
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Medication nonadherence is a significant clinical problem among individuals taking statins. Poor adherence is often attributable to several reasons, yet most adherence interventions target a single reason. Baseline data were examined from a randomized clinical trial of 236 patients with hyperlipidemia. A latent class analysis was then performed on patients reporting any nonadherence (n = 109). A 4-class solution provided the most optimal fit and differentiation of classes. Class 1 (N = 59, 54%) included patients who reported occasionally forgetting. Class 2 (N = 16, 14%) represented patients who were concerned about side effects. Class 3 (N = 17, 16%) represented patients who reported out-of-routine life events as contributing to nonadherence. Class 4 (N = 17, 16%) represented patients who endorsed a large number reasons indiscriminately. Class membership was almost uniformly unrelated to any patient demographic factors or treatment arm. Each cluster of reasons defining these patients may be best addressed through different intervention strategies.
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Blalock, Dan V, Hayden B Bosworth, Bryce B Reeve and Corrine I Voils (2019). Co-occurring reasons for medication nonadherence within subgroups of patients with hyperlipidemia. Journal of behavioral medicine, 42(2). pp. 291–299. 10.1007/s10865-018-9954-3 Retrieved from https://hdl.handle.net/10161/29867.
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Daniel Blalock
I am a research scientist and Licensed Clinical Psychologist with a background in health services research, clinical psychology, and experimental psychology. My research interests include 1) the evaluation of current integrated behavioral health settings in health care systems to optimize future implementation efforts, 2) the development of novel integrated behavioral health strategies tailored to specific populations and healthcare system needs, 3) broad processes of behavior change and self-regulation, and 4) psychometric measurement of patient reported outcomes and research methods/statistics.
These interests have taken the form of specific research endeavors involving: a) large nonrandomized investigations of electronic health records data, b) development and evaluation of telehealth interventions to improve self-management of mental and physical health behaviors, and c) evaluation of patient-reported outcomes through telehealth modalities and in primary care, specialty care, and higher level of care settings.
To date, the content domains of most of my research have involved substance use (specifically alcohol, opioids, and tobacco), health behaviors (specifically medication adherence), mental health (specifically anxiety, depression, PTSD, and eating disorders), and health services utilization.
Hayden Barry Bosworth
Dr. Bosworth is a health services researcher and Deputy Director of the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) at the Durham VA Medical Center. He is also Vice Chair of Education and Professor of Population Health Sciences. He is also a Professor of Medicine, Psychiatry, and Nursing at Duke University Medical Center and Adjunct Professor in Health Policy and Administration at the School of Public Health at the University of North Carolina at Chapel Hill. His research interests comprise three overarching areas of research: 1) clinical research that provides knowledge for improving patients’ treatment adherence and self-management in chronic care; 2) translation research to improve access to quality of care; and 3) eliminate health care disparities.
Dr. Bosworth is the recipient of an American Heart Association established investigator award, the 2013 VA Undersecretary Award for Outstanding Achievement in Health Services Research (The annual award is the highest honor for VA health services researchers), and a VA Senior Career Scientist Award. In terms of self-management, Dr. Bosworth has expertise developing interventions to improve health behaviors related to hypertension, coronary artery disease, and depression, and has been developing and implementing tailored patient interventions to reduce the burden of other chronic diseases. These trials focus on motivating individuals to initiate health behaviors and sustaining them long term and use members of the healthcare team, particularly pharmacists and nurses. He has been the Principal Investigator of over 30 trials resulting in over 400 peer reviewed publications and four books. This work has been or is being implemented in multiple arenas including Medicaid of North Carolina, private payers, The United Kingdom National Health System Direct, Kaiser Health care system, and the Veterans Affairs.
Areas of Expertise: Health Behavior, Health Services Research, Implementation Science, Health Measurement, and Health Policy
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