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Aug 30, 2017

Patient-Provider Communication Impacts Adherence to Blood Pressure Medication

Study finds better communication results in higher likelihood of medication being taken as directed.

The quality of communication between patients and their doctors impacts whether or not patients take their medication as prescribed, based on a recent study of medication adherence among patients with high blood pressure.

Published in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes, this study looked at how communication between patients and clinicians affects medication-taking behaviors. The study included 92 low-income patients taking medication for high blood pressure and 27 primary care doctors who were treating them. The majority of patients were black, and most had been seeing the same provider for at least one year.

The goal of the study was to see whether better patient-provider communication improves medication adherence in patients with high blood pressure. High blood pressure is a major risk factor for heart disease and stroke, which affects 1 in 3 U.S. adults. It’s estimated that only half of people with high blood pressure have their condition under control, often due to poor adherence to treatment.

At the start of the study, researchers taped each office visit and scored it based on the quality of patient-provider interactions. Scores for visits were based on how well doctors communicated with their patients, like by asking open-ended questions, listening to patient concerns, helping address possible barriers to treatment, and providing patients with support and reassurance. The more patient-centered a visit was, the higher score it received.

Following the recorded visit, researchers then tracked participants’ adherence to blood pressure medication for the next three months using electronic pill caps.

By the end of the study, researchers found that 58% of patients had poor adherence to their blood pressure-lowering medications. After analysis, three key categories of communication had a strong impact on medication adherence: patient-centeredness, discussion about patients’ home lives and discussion about their blood pressure medication. The less a provider addressed these topics, the less likely patients were to take their medications as directed.

Researchers also noted that failing to address home life, such as living situation and relationship with a partner, had an even greater negative impact on medication adherence in black participants than in whites.

What this study shows, according to experts, is the importance of talking with patients rather than at them. While it’s important that patients understand their condition and treatment, it’s equally as important that doctors understand each patient’s situation and help address the unique challenges faced when managing chronic conditions. Findings also suggest that communication may be especially important for minorities, and may be a key to helping eliminate health disparities. As experts explain, communication helps build trust. Patients who trust their clinicians are more likely to follow their recommendations to improve their health.

Questions for You to Consider

  • What is hypertension?
  • Hypertension, often referred to as high blood pressure, occurs when the force of blood against the artery walls is too high. High blood pressure is often referred to as the “silent killer,” because it often causes no symptoms and if left uncontrolled, increases risk for heart attack and stroke.
  • Who is at risk for high blood pressure?
  • Risk for hypertension increases with age, and most adults will eventually be affected by this condition at some time in their lives. However, diabetes, obesity, stress, high sodium intake, tobacco use and excessive alcohol use can greatly increase risk for high blood pressure.

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