title: Patient centered primary care is associated with patient hypertension medication adherence.
abstract: There is increasing evidence that patient centered care, including communication skills, is an essential component to chronic illness care. Our aim was to evaluate patient centered primary care as a determinant of medication adherence. We mailed 1,341 veterans with hypertension the Short Form Primary Care Assessment Survey (PCAS) which measures elements of patient centered primary care. We prospectively collected each patient's antihypertensive medication adherence for 6 months. Patients were characterized as adherent if they had medication for >80%. 654 surveys were returned (50.7%); and 499 patients with complete data were analyzed. Antihypertensive adherence increased as scores in patient centered care increased [RR 3.18 (95% CI 1.44, 16.23) bootstrap 5000 resamples] for PCAS score of 4.5 (highest quartile) versus 1.5 (lowest quartile). Future research is needed to determine if improving patient centered care, particularly communication skills, could lead to improvements in health related behaviors such as medication adherence and health outcomes.
authors.affiliation: VA Tennessee Valley Healthcare, Tennessee Valley Geriatric Research Education Clinical Center (GRECC), Nashville, TN 37212, USA. christianne.roumie@vanderbilt.edu
authors.forename: Christianne L
authors.initials: CL
authors.lastname: Roumie
authors.forename: Robert
authors.initials: R
authors.lastname: Greevy
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Wallston
authors.forename: Tom A
authors.initials: TA
authors.lastname: Elasy
authors.forename: Lisa
authors.initials: L
authors.lastname: Kaltenbach
authors.forename: Kristen
authors.initials: K
authors.lastname: Kotter
authors.forename: Robert S
authors.initials: RS
authors.lastname: Dittus
authors.forename: Theodore
authors.initials: T
authors.lastname: Speroff
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001294:Attitude to Health; D001794:Blood Pressure / Q000187:drug effects; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000523:psychology*; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000379:methods*; D011320:Primary Health Care / Q000379:methods*; D014728:Veterans / Q000523:psychology; D016903:Drug Monitoring
chemical_list: D000959:Antihypertensive Agents