title: Approach to antihypertensive adherence: a feasibility study on the use of student health coaches for uninsured hypertensive adults.
abstract: Despite pharmacologic advances, medication non-adherence continues to challenge primary care providers in blood pressure (BP) management. Medical, nursing and pharmacy students (n=11) were recruited and trained as health coaches for uninsured, hypertensive patients (n=25) of a free clinic in an uncontrolled open trial. Pre-post analysis was conducted on BP, medication adherence, frequency of home BP monitoring, and health behavior (eg, diet, exercise). Patient satisfaction and feasibility of a student coach model was qualitatively evaluated. In the 12 patients who completed the intervention, an increase in medication adherence as measured by the Brief Medication Questionnaire was observed (P<.01), with a 11 mmHg reduction in systolic BP (P=.03). Qualitative data showed patient satisfaction with the intervention and other health behavior change. This feasibility study shows use of student health coaches to combat medication non-adherence in uninsured, hypertensive adults is promising.
authors.affiliation: The Warren Alpert Medical School, Brown University and The Miriam Hospital, Rhode Island Free Clinic, RI, USA. lleung@mednet.ucla.edu
authors.forename: Lucinda B
authors.initials: LB
authors.lastname: Leung
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Busch
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Nottage
authors.forename: Naira
authors.initials: N
authors.lastname: Arellano
authors.forename: Eva
authors.initials: E
authors.lastname: Glieberman
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Busch
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Smith
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D018660:Blood Pressure Monitoring, Ambulatory / Q000523:psychology / Q000706:statistics & numerical data; D037001:Directive Counseling / Q000379:methods / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000523:psychology*; D008297:Male; D017057:Medically Uninsured / Q000523:psychology* / Q000706:statistics & numerical data; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012237:Rhode Island; D016903:Drug Monitoring
chemical_list: D000959:Antihypertensive Agents