title: Associations between home remedy use and a validated self-reported adherence measure in an urban African-American population with poorly controlled hypertension.
abstract: OBJECTIVE
  To determine associations between home remedy use and self-reported adherence among urban African Americans with poorly controlled hypertension.
  
  
  METHODS
  A cross-sectional structured interview of African Americans admitted to medical units for uncontrolled hypertension at an urban academic hospital from 1999-2004. Logistic regression was used to test associations between home remedy use and self-reported adherence.
  
  
  RESULTS
  One-hundred-eighty-three of 272 participants completed the study (67%); 39 (21%) reported using home remedies for hypertension. In a multivariate model, home remedy use was independently associated with greater medication adherence (OR for nonadherence=0.32, 95% CI: 0.14-0.75; p<0.01) and dietary adherence (OR for changing diet=3.28, 95% CI: 1.10-9.81; p=0.03), but not lifestyle or appointment adherence. These associations remained strong while controlling for age; sex; employment status; and key covariates, including greater medication side effects (OR=4.31; 95% CI: 1.64-11.3; p<0.01), greater difficulty paying for medications (OR=2.94, 95% CI: 1.25-6.92; p=0.01) and longer duration of diagnosis (OR for log years=1.53; 95% CI: 1.02-2.33; p=0.045).
  
  
  CONCLUSIONS
  Home remedy use may be a marker of positive self-care for some hypertensive African Americans and not a promoter of nonadherence.
authors.affiliation: Division of General Internal Medicine, Johns Hopkins University School of Medicine, USA. tilburt.jon@mayo.edu
authors.forename: Jon C
authors.initials: JC
authors.lastname: Tilburt
authors.forename: Sydney Morss
authors.initials: SM
authors.lastname: Dy
authors.forename: Kristina
authors.initials: K
authors.lastname: Weeks
authors.forename: Michael
authors.initials: M
authors.lastname: Klag
authors.forename: J Hunter
authors.initials: JH
authors.lastname: Young
mesh_terms: D044383:Black People; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008519:Medicine, Traditional; D008875:Middle Aged; D010349:Patient Compliance; D012648:Self Care; D014505:Urban Population; D001741:Black or African American