The effect of a practice‐based multicomponent intervention that includes health coaching on medication adherence and blood pressure control in rural primary care |
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| Authors: | Jia‐Rong Wu PhD Doyle M Cummings PharmD FCP FCCP Quefeng Li PhD Alan Hinderliter MD Hayden B Bosworth PhD Jimmy Tillman MDiv Darren DeWalt MD MPH |
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| Institution: | 1. School of Nursing, University of North Carolina, Chapel Hill, NC, USA;2. Department of Family Medicine, Brody School of Medicine at East Carolina University, Greenville, NC, USA;3. School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA;4. Department of Biostatistics, Gillings School of Global Public Health, Chapel Hill, NC, USA;5. Division of Cardiology, School of Medicine, Chapel Hill, NC, USA;6. Department of Population Health Sciences at Duke University, Durham, NC, USA;7. Open Water Coaching and Consulting, LLC, Cape Carteret, NC, USA;8. Department of General Internal Medicine, School of Medicine, Chapel Hill, NC, USA |
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| Abstract: | Low adherence to anti‐hypertensive medications contributes to worse outcomes. The authors conducted a secondary data analysis to examine the effects of a health‐coaching intervention on medication adherence and blood pressure (BP), and to explore whether changes in medication adherence over time were associated with changes in BP longitudinally in 477 patients with hypertension. Data regarding medication adherence and BP were collected at baseline, 6, 12, 18, and 24 months. The intervention resulted in increases in medication adherence (5.75→5.94, P = .04) and decreases in diastolic BP (81.6→76.1 mm Hg, P < .001) over time. The changes in medication adherence were associated with reductions in diastolic BP longitudinally (P = .047). Patients with low medication adherence at baseline had significantly greater improvement in medication adherence and BP over time than those with high medication adherence. The intervention demonstrated improvements in medication adherence and diastolic BP and offers promise as a clinically applicable intervention in rural primary care. |
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| Keywords: | blood pressure health‐coaching intervention hypertension medication adherence |
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