OBJECTIVES: To examine the associations between racial/ethnic concordance and blood pressure (BP) control, and to determine whether patient trust and medication adherence mediate these associations. DESIGN: Cross-sectional study of 723 hypertensive African-American and white patients receiving care from 205 white and African-American providers at 119 primary care clinics, from 2001 to 2005. Racial/ethnic concordance was characterized as dyads where both the patient and physician were of the same race/ethnicity; discordance occurred in dyads where the patient was African-American and the physician was white. Patient perceptions of trust and medication adherence were assessed with self-report measures. The BP readings were abstracted from patients' medical charts using standardized procedures. RESULTS: Six hundred thirty-seven patients were in race/ethnic-concordant relationships; 86 were in race/ethnic-discordant relationships. Concordance had no association with BP control. White patients in race/ethnic-concordant relationships were more likely to report better adherence than African-American patients in race/ethnic-discordant relationships (OR: 1.27, 95% CI: 1.01, 1.61, p = 0.04). Little difference in adherence was found for African-American patients in race/ethnic-concordant vs. discordant relationships. Increasing trust was associated with significantly better adherence (OR: 1.17, 95% CI: 1.04, 1.31, p < 0.01) and a trend toward better BP control among all patients (OR: 1.26, 95% CI: 0.97, 1.63, p = 0.07). CONCLUSIONS: Patient trust may influence medication adherence and BP control regardless of patient-physician racial/ethnic composition.
OBJECTIVES: To examine the associations between racial/ethnic concordance and blood pressure (BP) control, and to determine whether patient trust and medication adherence mediate these associations. DESIGN: Cross-sectional study of 723 hypertensive African-American and white patients receiving care from 205 white and African-American providers at 119 primary care clinics, from 2001 to 2005. Racial/ethnic concordance was characterized as dyads where both the patient and physician were of the same race/ethnicity; discordance occurred in dyads where the patient was African-American and the physician was white. Patient perceptions of trust and medication adherence were assessed with self-report measures. The BP readings were abstracted from patients' medical charts using standardized procedures. RESULTS: Six hundred thirty-seven patients were in race/ethnic-concordant relationships; 86 were in race/ethnic-discordant relationships. Concordance had no association with BP control. White patients in race/ethnic-concordant relationships were more likely to report better adherence than African-American patients in race/ethnic-discordant relationships (OR: 1.27, 95% CI: 1.01, 1.61, p = 0.04). Little difference in adherence was found for African-American patients in race/ethnic-concordant vs. discordant relationships. Increasing trust was associated with significantly better adherence (OR: 1.17, 95% CI: 1.04, 1.31, p < 0.01) and a trend toward better BP control among all patients (OR: 1.26, 95% CI: 0.97, 1.63, p = 0.07). CONCLUSIONS:Patient trust may influence medication adherence and BP control regardless of patient-physician racial/ethnic composition.
Authors: Mallory O Johnson; Margaret A Chesney; Rise B Goldstein; Robert H Remien; Sheryl Catz; Cheryl Gore-Felton; Edwin Charlebois; Stephen F Morin Journal: AIDS Patient Care STDS Date: 2006-04 Impact factor: 5.078
Authors: Lisa C Welch; Heather J Litman; Christina P C Borba; Brenda Vincenzi; David C Henderson Journal: Health Serv Res Date: 2014-12-09 Impact factor: 3.402
Authors: David T Eton; Kathleen J Yost; Jin-Shei Lai; Jennifer L Ridgeway; Jason S Egginton; Jordan K Rosedahl; Mark Linzer; Deborah H Boehm; Azra Thakur; Sara Poplau; Laura Odell; Victor M Montori; Carl R May; Roger T Anderson Journal: Qual Life Res Date: 2016-08-26 Impact factor: 4.147