Medication adherence in older clinic patients with hypertension after Hurricane Katrina: implications for clinical practice and disaster management

Am J Med Sci. 2008 Aug;336(2):99-104. doi: 10.1097/MAJ.0b013e318180f14f.

Abstract

Background: In post-disaster situations, additional barriers may reduce antihypertensive medication adherence.

Methods: Between November 2005 and August 2006, 210 hypertensive patients receiving care at a multispecialty group practice in New Orleans completed a structured questionnaire. Antihypertensive medication adherence was measured with the Hill-Bone medication compliance subscale. In a subset of patients, data on difficulties patients encountered with blood pressure medications in the aftermath of Hurricane Katrina were collected.

Results: : Seventy-six percent of patients reported damage to their residence and 46% of patients had less-than-perfect medication adherence. After multivariate adjustment, less than perfect medication adherence postdisaster was more common among people aged <65 years (prevalence ratio = 1.37; 95% confidence interval: 1.03-1.82) and non-whites (1.32; 95% confidence interval: 1.02-1.71). Uncontrolled blood pressure (systolic/diastolic > or =140/> or =90 mm Hg) was more common in those with less-than-perfect adherence than their counterparts with perfect adherence (51% versus 42%, respectively). In addition, 7% of patients reported not bringing their blood pressure medications when they evacuated, 28% ran out of blood pressure medications, 16% reported difficulties getting medications filled, and 28% reported a blood pressure medication change postdisaster.

Conclusions: Opportunities exist to improve disaster planning and prescription refill processes and increase medication adherence and hypertension control postdisasters.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Disasters*
  • Female
  • Humans
  • Hypertension / epidemiology
  • Hypertension / physiopathology
  • Hypertension / therapy*
  • Louisiana
  • Male
  • Middle Aged
  • Patient Compliance / statistics & numerical data*
  • Relief Work*
  • Sociology, Medical
  • Surveys and Questionnaires