Perceived Barriers to Medication Adherence in Latinos with Hypertension Using the World Health Organization Multidimensional Adherence Model

By Chelsea Martinez

 

Project Description 

Recent data indicates that hypertensive Latino adults reported the lowest adherence to their medications (67%) when compared with Black and White adults (77% for both groups) (Schoenthaler et al., 2019). As a result, a lack of medication adherence (MA) among Latinos/Hispanics with hypertension (HTN) leads to higher HTN-related mortality at a faster rate in Latinos than in other ethnic groups (Schoenthaler et al., 2019). Suboptimal MA is a main contributor to chronic conditions in this community, including HTN. For context, Hispanics/Latinos are an underrepresented population in research (Dreyfus et al., 2023). The current research on barriers to MA in the hypertensive population is often not tailored to Latinos, the largest racial and ethnic minority in The United States (US Census Bureau, 2023). Currently, Hispanics have a prevalence of HTN of 43.7 percent (Ostchega et al., 2020). With a rapidly growing population and significant HTN prevalence, it is imperative that effective interventions to increase MA are developed. However, without research that aims to identify the primary barriers to MA within the population, effective and efficient interventions cannot be tailored. 

       Therefore, the objective of this study is to identify the primary barriers to MA within the hypertensive Latino population in the Greater New Bedford area by utilizing the World Health Organization’s Multidimensional Adherence Model (WHOs MAM) (Sabaté, 2003). The barriers within the MAM include personal, socioeconomic, therapy, health care, and condition-related factors. Using quantitative data, this project aims to find the positive and negative associations between certain dimensions delineated by the MAM and self-reported MA. Participants have been chosen based on a convenience sample of 20 Hispanics/Latinos with HTN from the health clinic at the Community and Economic Development Center (CEDC) in New Bedford, as facilitated by the director, Corinne Williams. Participants have also been recruited from Southcoast Health’s Cardiology office, facilitated by Vicki Saint-Paine, a nurse practitioner at the clinic. Materials include instruments that measure MA and personal beliefs about medication and healthcare. An iPad is being used to show educational videos that compose the brief teaching intervention on MA. Participants have only spoken English and Spanish so far. As a native Spanish speaker, I have translated the surveys into Spanish and have distributed the translations as needed. 

       Ultimately, the purpose of this research is to build on the information known about MA and the barriers that affect the Latino population. This will be done with the hope of discovering the prevalent personal, condition, therapy, socioeconomic, and healthcare-related barriers to MA to understand and discover specific aspects of adherence that can influence the establishment of effective interventions. 

Progress 

As of June 28, 2024, I have 20 enrolled participants for the study. This is the total number of participants needed for the study. Only thirteen participants have completed the study; the remaining seven participants are scheduled to participate in the study within the next week. This also signifies that thirteen of the ten-dollar Market Basket gift cards have been distributed, with seven left. Thirteen out of 20 participants have been recruited from the CEDC. The paper surveys are used and then entered into Qualtrics. My goal is to finish surveying participants by the second week of July. I am grateful to the OUR and its committee once again for giving me this opportunity and allowing me to provide participants with an incentive.

 

References 

Dreyfus, B., Kuri, L., Ferri, M., Doykos, P., Fazeli, M. S., Hofer, K., Andonova, A., Ferri, L. (2023). Understanding Hispanic/Latino Participation in Clinical Trials and Observational Studies, and Strategies to Increase Participation: A Targeted Literature Review. Journal of Health Care for the Poor & Underserved, 34(1), 399–424. https://doi- org.libproxy.umassd.edu/10.1353/hpu.2023.0026 

Kvarnström, K., Westerholm, A., Airaksinen, M., & Liira, H. (2021). Factors Contributing to Medication Adherence in Patients with a Chronic Condition: A Scoping Review of Qualitative Research. Pharmaceutics, 13(7), 1100. https://doi.org/10.3390/pharmaceutics13071100 

Ostchega, Y., Fryar, C. D., Nwankwo, T., & Nguyen, D. T. (2020, April 24). Hypertension Prevalence Among Adults Aged 18 and Over: United States, 2017–2018. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/products/databriefs/db364.htm#:~:text=In%20survey%20perio d%202017%E2%80%932018,%25%20(60%20and%20over). 

Sabaté, E. (2003). Adherence to long-term therapies: Evidence for Action. World Health Organization 

Schoenthaler, A., de la Calle, F., Pitaro, M., Lum, A., Chaplin, W., Mogavero, J., & Rosal, M. C. (2020). A Systems-Level Approach to Improving Medication Adherence in Hypertensive Latinos: a Randomized Control Trial. Journal of general internal medicine, 35(1), 182–189. https://doi.org/10.1007/s11606-019-05419-3 

US Census Bureau. (2023, September 28). Hispanic Heritage Month: 2023. Census.gov. https://www.census.gov/newsroom/facts-for-features/2023/hispanic-heritage-month.html