Medication adherence in older clinic patients with hypertension after Hurricane Katrina: implications for clinical practice and disaster management.
BACKGROUND
In post-disaster situations, additional barriers may reduce antihypertensive medication adherence.


METHODS
Between November 2005 and August 2006, 210 hypertensive patients receiving care at a multispecialty group practice in New Orleans completed a structured questionnaire. Antihypertensive medication adherence was measured with the Hill-Bone medication compliance subscale. In a subset of patients, data on difficulties patients encountered with blood pressure medications in the aftermath of Hurricane Katrina were collected.


RESULTS
: Seventy-six percent of patients reported damage to their residence and 46% of patients had less-than-perfect medication adherence. After multivariate adjustment, less than perfect medication adherence postdisaster was more common among people aged <65 years (prevalence ratio = 1.37; 95% confidence interval: 1.03-1.82) and non-whites (1.32; 95% confidence interval: 1.02-1.71). Uncontrolled blood pressure (systolic/diastolic > or =140/> or =90 mm Hg) was more common in those with less-than-perfect adherence than their counterparts with perfect adherence (51% versus 42%, respectively). In addition, 7% of patients reported not bringing their blood pressure medications when they evacuated, 28% ran out of blood pressure medications, 16% reported difficulties getting medications filled, and 28% reported a blood pressure medication change postdisaster.


CONCLUSIONS
Opportunities exist to improve disaster planning and prescription refill processes and increase medication adherence and hypertension control postdisasters.
Krousel-Wood
Marie A
MA
Center for Health Research, Ochsner Clinic Foundation, New Orleans, Louisiana, USA. mawood@ochsner.org
Islam
Tareq
T
Muntner
Paul
P
Stanley
Erin
E
Phillips
Ashli
A
Webber
Larry S
LS
Frohlich
Edward D
ED
Re
Richard N
RN
D000368:Aged; D004190:Disasters; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012066:Relief Work; D012962:Sociology, Medical; D011795:Surveys and Questionnaires