Patients' perceptions of electronic monitoring devices affect medication adherence in hypertensive African Americans

Antoinette Schoenthaler, Olugbenga Ogedegbe

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Electronic monitoring devices (EMDs) are regarded as the gold standard for assessing medication adherence in clinical research. However, little is known about the effect of patients' acceptance of EMDs on medication adherence in African Americans with hypertension who are followed in primary care practices OBJECTIVE: To assess patients' perceptions of EMDs, their acceptance of EMDs, and the relationship of these perceptions to medication adherence in African Americans with hypertension who are followed in community-based practices. METHODS: Patients were recruited from a larger randomized controlled trial assessing the effect of motivational interviewing on medication adherence and blood pressure in hypertensive African American patients followed in 2 New York City primary care practices. Medication adherence was assessed with a Medication Event Monitoring System (MEMS) during a 12-month monitoring period. At the 12-month follow-up, patients' perceptions of the MEMS were assessed with a 17-item questionnaire. ANOVA was used to compare patients' responses (agree, neither, disagree) with the MEMS adherence over the monitoring period. Tukey's post hoc tests were used to determine whether there were significant differences among the 3 groups. RESULTS: Participants were predominantly women, low-income, unemployed, had a high school education, and were a mean age of 53 years. Approximately two-thirds of the participants stated that the MEMS helped them remember to take their medications, 93% reported that the MEMS was easy to open, 85% did not find it stressful, and 75% liked the MEMS and used it everyday. One-third of patients preferred using a pillbox and 25% did not like traveling with the MEMS. Patients who stated that they used the MEMS every day, felt comfortable using it in front of others, and remembered to put refills in the MEMS had significantly better adherence over the study period than did those who disagreed (p ≤ 0.05). CONCLUSIONS: African American patients treated for hypertension in community-based practices held positive perceptions about a MEMS. Perceptions about the practicality of a MEMS may yield important information about actual medication-taking behavior.

Original languageEnglish (US)
Pages (from-to)647-652
Number of pages6
JournalAnnals of Pharmacotherapy
Volume42
Issue number5
DOIs
StatePublished - May 2008

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Medication Adherence
African Americans
Equipment and Supplies
Hypertension
Primary Health Care
Motivational Interviewing
Analysis of Variance
Randomized Controlled Trials
Blood Pressure
Education

Keywords

  • Adherence
  • African American
  • Electronic monitoring devices
  • Hypertension

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Patients' perceptions of electronic monitoring devices affect medication adherence in hypertensive African Americans. / Schoenthaler, Antoinette; Ogedegbe, Olugbenga.

In: Annals of Pharmacotherapy, Vol. 42, No. 5, 05.2008, p. 647-652.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Electronic monitoring devices (EMDs) are regarded as the gold standard for assessing medication adherence in clinical research. However, little is known about the effect of patients' acceptance of EMDs on medication adherence in African Americans with hypertension who are followed in primary care practices OBJECTIVE: To assess patients' perceptions of EMDs, their acceptance of EMDs, and the relationship of these perceptions to medication adherence in African Americans with hypertension who are followed in community-based practices. METHODS: Patients were recruited from a larger randomized controlled trial assessing the effect of motivational interviewing on medication adherence and blood pressure in hypertensive African American patients followed in 2 New York City primary care practices. Medication adherence was assessed with a Medication Event Monitoring System (MEMS) during a 12-month monitoring period. At the 12-month follow-up, patients' perceptions of the MEMS were assessed with a 17-item questionnaire. ANOVA was used to compare patients' responses (agree, neither, disagree) with the MEMS adherence over the monitoring period. Tukey's post hoc tests were used to determine whether there were significant differences among the 3 groups. RESULTS: Participants were predominantly women, low-income, unemployed, had a high school education, and were a mean age of 53 years. Approximately two-thirds of the participants stated that the MEMS helped them remember to take their medications, 93{\%} reported that the MEMS was easy to open, 85{\%} did not find it stressful, and 75{\%} liked the MEMS and used it everyday. One-third of patients preferred using a pillbox and 25{\%} did not like traveling with the MEMS. Patients who stated that they used the MEMS every day, felt comfortable using it in front of others, and remembered to put refills in the MEMS had significantly better adherence over the study period than did those who disagreed (p ≤ 0.05). CONCLUSIONS: African American patients treated for hypertension in community-based practices held positive perceptions about a MEMS. Perceptions about the practicality of a MEMS may yield important information about actual medication-taking behavior.",
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