Study explores associations between patient-clinician relationships and taking medications regularly among Black adults


November 2, 2021

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A study co-authored by Macarius Donneyong, PhD, MPh, assistant professor of Outcomes and Translational Sciences at The Ohio State University College of Pharmacy, found that patient-clinician relationships with poor communication and a lack of shared decision making (SDM) in health care treatments can disproportionately affect Black adults when it comes to taking high blood pressure medication consistently.

The study, titled, “Association Between PatientClinician Relationships and Adherence to Antihypertensive Medications Among Black Adults: An Observational Study Design,” published in the Journal of the American Heart Association, pulls data from 2010 to 2017 in the Medical Expenditure Panel Survey (MEPS) – a large-scale national survey that gives a complete source of data on the cost and use of health care and health insurance coverage of families and individuals and their providers and employers.

Taking medications consistently is defined in the study as patients filling their high-blood pressure medications ≥80% of the time. Anything below this number indicates that patients fluctuate taking their medications. Overall, about 40% of Black adult hypertension patients reported taking their high-blood pressure medication consistently per their doctor’s recommendation; in contrast nearly 50% of non-Hispanic Whites consistently took their high-blood pressure medications. Black adult hypertension patients also reported having less than optimal communication and involvement in SDM; only 45% and 43% of these patients reported that their communication and SDM with their healthcare provider were optimal.

As expected, the Black adult hypertension patients who reported having optimal communication and felt their provider involved them in making decisions about their health were more likely to consistently take their high-blood pressure medications compared to those who reported having less communication and less involvement in making decisions about their health. Surprisingly, however, having optimal communication and higher involvement in making decisions were not associated with taking high-blood pressure medication consistently among non-Hispanic Whites, Hispanics and other racial/ethnic groups.

The results of this study suggests that consistent use of high-blood pressure medications among Black adult hypertension patients could possibly be improved through effective patient-provider communication and high levels of patient involvement in SDM processes. Therefore,  the researchers recommend that clinicians and health care systems consider emphasizing communication and SDM processes within patientcentered models as a strategy to improve taking medication regularly among Black adult patients with high-blood pressure.

Given that patient-provider communication and involvement in SDM were associated with the consistent use of high-blood pressure medications among Black adult hypertension patients, future research is needed on whether improving patientprovider relationships can close racial/ethnic disparities and boost taking high-blood pressure medication consistency.

Other researchers involved in this study were Teng-Jen Chang, John F.P. Bridges, Mary Bynum, John W. Jackson, Joshua J. Joseph, Michael A. Fischer and Bo Lu.