January 22, 2019
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Good health literacy improves antihypertensive adherence in Hispanics

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Hispanic patients with hypertension and good health literacy had improved adherence to BP medications, although levels of health literacy and adherence were low in this group overall, according to a study published in the Journal of Racial and Ethnic Health Disparities.

“When considering health literacy, for example, it is important to assess a patient’s understanding of the dose and purpose of the antihypertensive and use visual aids for individuals with low health literacy,” Ann-Margaret Navarra, PhD, CPNP-PC, assistant professor at New York University Rory Meyers College of Nursing, said in a press release. “However, it is equally important to ask about other modifiable factors for suboptimal adherence, including sleep disturbances and mental health issues, as we found these variables to be associated with lower antihypertensive adherence levels.”

Maichou Lor, PhD, RN, postdoctoral research fellow at Columbia University School of Nursing, and colleagues analyzed data from 1,355 Hispanic patients (mean age, 62 years; 76% women; 90% born in the Dominican Republic) with self-reported hypertension. Patients were recruited by trained bilingual community health workers who helped conduct surveys to collect information on demographics, health information, health literacy and symptom status regarding depression, anxiety and sleep. Adherence to antihypertensive medications was also self-reported.

Of the patients in the study, 84.9% had inadequate health literacy and low adherence levels to antihypertensive medications (88.4%).

Patients with adequate health literacy levels had a higher adherence score compared with those with inadequate health literacy levels after adjusting for sex, age, education level, birth country, recruitment location, depression, anxiety and sleep disturbance (beta = 0.378; P = .043).

Researchers found that 13.6% of the variance in medication adherence was explained with the full model (P < .001). In addition, health literacy minimally contributed to the model (R2 change = .003)

“Further intervention could be tailored to reflect sex differences and consider care settings to improve antihypertensive medication adherence among Hispanics,” Lor and colleagues wrote. “Moving forward, an important search priority is the need for studies designed to identify and prioritize factors in the development of tailored and effective adherence interventions for Hispanics with [hypertension].” – by Darlene Dobkowski

Disclosures: The authors report no relevant financial disclosures.