Helping Hypertensive Latinos to Improve Medication Adherence
Condition: Hypertension
MeSH terms: Hypertension
Study type: Interventional

Summary: 
      Poor medication adherence is a major contributor to inadequate BP control, and is associated
      with 125,000 deaths annually. Translation of adherence interventions to community-based
      primary care practices where majority of Latino patients receive care is non-existent. Thus,
      the development of tailored interventions targeted at improving medication adherence in the
      Latino population is needed in order to address the racial disparities in BP control between
      Latinos and whites. This proposal provides a unique opportunity to address this gap in the
      literature. Using a randomized control design (RCT), the study will evaluate the effect of a
      culturally tailored, practice-based intervention on medication adherence in 148 high-risk
      Latino patients with uncontrolled HTN. To facilitate translation into routine practices, the
      intervention will be integrated into the clinic's electronic medical record (EMR) system, and
      will be delivered by trained, bilingual Health Coaches.
    

Detailed description: 
      Latinos are the fastest growing ethnic group of the U.S. with a growth rate of 43% compared
      to 23% among whites over the past decade. This increase is four times the nation's 9.7%
      growth rate, and accounts for more than half of the total U.S. population increase of 27.3
      million during this period. This growth is accompanied by a significant increase in
      cardiovascular disease (CVD)-related morbidity and mortality. Despite increasing trends in
      the awareness and treatment of hypertension (HTN) among all groups, Latinos have the lowest
      blood pressure (BP) control rates in the U.S. Although barriers to optimal HTN control such
      as poor access, and low awareness have been used to explain the disparities in BP control
      between Latinos and whites, BP control rates remain lower among Latinos who receive treatment
      compared to whites. This enigma may be explained by the disproportionately poorer adherence
      to prescribed antihypertensive medications among Latinos compared to whites. Poor medication
      adherence is a major contributor to inadequate BP control, and is associated with 125,000
      deaths annually. Despite over 30 years of research dedicated to understanding adherence
      behaviors in hypertensive patients, data in Latino patients is scant. More importantly,
      translation of adherence interventions to community-based primary care practices where
      majority of Latino patients receive care is non-existent.
    

Intervention name(s): Adherence Intervention; Usual Care
Intervention type(s): Behavioral; Behavioral
Intervention description(s): 9 sessions with bilingual health coaches who will utilize a culturally tailored adherence checklist to identify patients specific medication adherence barriers.; standard hypertension treatment recommendations as determined by PCP
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: Latino