Short Form (SF-36) Health Survey Measures are Associated with Decreased Adherence among Urban African-Americans with Severe Poorly Controlled Hypertension

摘要

The objective of this study was to determine if an association exists between SF-36 measures and nonadherence among urban African-Americans with poorly controlled hypertension. 158 African-Americans admitted to an urban academic hospital for severe, uncontrolled hypertension. Main outcome measure was self-reported nonadherence to antihypertensive medications using a validated instrument. For every 10-point increase in Physical Component Summary (PCS) score, an individual was almost two times more likely to report being nonadherent (OR 1.94, 95%CI 1.30-2.90; p<0.01). A significant interaction (p=0.05) was observed between the Physical Functioning and Mental Health subscales; individuals with high Physical Functioning and low Mental Health scores displayed the lowest adherence rate. These results suggest that high physical functioning, especially if associated with poor mental health, increases the likelihood of nonadherence to antihypertensive regimens among urban African-Americans. The SF-36 may serve as an effective clinical tool that identifies patients at risk for nonadherence, and more importantly, may improve clinicians’ understanding of nonadherence, allowing for discussions about antihypertensives to be tailored to individual patients.