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Patient centered primary care is associated with patient hypertension medication adherence

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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.

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Acknowledgments

This material is based upon work supported by the Veterans Affairs Clinical Research Center of Excellence and the Geriatric Research Education and Clinical Center Tennessee Valley Healthcare System, Nashville Tennessee. VA Career Development Transition Award 04-342-2.

Conflicts of interest

There are no conflicts of interest to disclose. The principal investigators and co-investigators had full access to the data and were responsible for the study protocol, statistical analysis plan, progress of the study, analysis, reporting of the study and the decision to publish.

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Authors and Affiliations

  1. VA Tennessee Valley Healthcare, Tennessee Valley Geriatric Research Education Clinical Center (GRECC), Nashville, TN, USA

    Christianne L. Roumie, Robert Greevy, Kenneth A. Wallston, Tom A. Elasy, Kristen Kotter, Robert S. Dittus & Theodore Speroff

  2. HSR&D Targeted Research Enhancement Program Center for Patient Healthcare Behavior, Nashville, TN, USA

    Christianne L. Roumie, Robert Greevy, Kenneth A. Wallston, Tom A. Elasy, Kristen Kotter, Robert S. Dittus & Theodore Speroff

  3. Tennessee Valley VA Clinical Research Training Center of Excellence (CRCoE), Nashville, TN, USA

    Christianne L. Roumie, Robert Greevy & Kristen Kotter

  4. Department of Medicine, Vanderbilt University, Nashville, TN, USA

    Christianne L. Roumie, Tom A. Elasy, Robert S. Dittus & Theodore Speroff

  5. VA National Quality Scholars Program, Nashville, TN, USA

    Christianne L. Roumie, Tom A. Elasy, Robert S. Dittus & Theodore Speroff

  6. Department of Biostatistics, Vanderbilt University, Nashville, TN, USA

    Robert Greevy, Kristen Kotter & Theodore Speroff

  7. School of Nursing, Vanderbilt University, Nashville, TN, USA

    Kenneth A. Wallston

  8. Duke Clinical Research Institute, Durham, NC, USA

    Lisa Kaltenbach

  9. Department of Preventive Medicine, Vanderbilt University, Nashville, TN, USA

    Theodore Speroff

  10. Nashville VA Medical Center, 1310 24th Ave South GRECC 4B120, Nashville, TN, 37212, USA

    Christianne L. Roumie

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  1. Christianne L. Roumie
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  2. Robert Greevy
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  3. Kenneth A. Wallston
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  7. Robert S. Dittus
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  8. Theodore Speroff
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Correspondence to Christianne L. Roumie.

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Roumie, C.L., Greevy, R., Wallston, K.A. et al. Patient centered primary care is associated with patient hypertension medication adherence. J Behav Med 34, 244–253 (2011). https://doi.org/10.1007/s10865-010-9304-6

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