Barriers to Medication Adherence and Mild Cognitive Impairment Among African Americans with Persistently Uncontrolled Hypertension: A Cross-sectional Analysis from the Southeastern Collaboration Trial.
Academic Article
Overview
abstract
BACKGROUND: Mild cognitive impairment (MCI) is frequently undetected and may lead to medication nonadherence. We examined whether more reported barriers to medication adherence could signal the presence of MCI. OBJECTIVE: We developed a count of barriers (0, 1, 2, and ≥3) and determined the independent association between a greater number of barriers and odds of MCI. SETTING: Rural primary care practices in Alabama and North Carolina. PARTICIPANTS: One thousand two hundred seventy-nine participants of the Southeastern Collaboration to Improve Blood Pressure Control trial; all were African Americans with persistently uncontrolled hypertension. MAIN MEASURE: Presence of mild cognitive impairment (MCI). RESULTS: Participants reporting ≥ 2 barriers had 2.40 (95% CI 1.03-5.75) times higher adjusted odds of MCI compared to those reporting none; those reporting ≥ 3 barriers had 3.80 (95% CI 1.74-8.31) higher odds. As the number of barriers increased, odds of MCI increased (p for trend < 0.001). CONCLUSION: Barriers to medication adherence may signal MCI.
