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Impact of continuity of care and pro...

Shermock, Kenneth M.

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Impact of continuity of care and provider factors on medication adherence in patients with hypertension.

Record Type:	Language materials, printed : Monograph/item
Title/Author:	Impact of continuity of care and provider factors on medication adherence in patients with hypertension./
Author:	Shermock, Kenneth M.
Description:	160 p.
Notes:	Source: Dissertation Abstracts International, Volume: 71-01, Section: B, page: 2630.
Contained By:	Dissertation Abstracts International71-01B.
Subject:	Health Sciences, Public Health. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3392383
ISBN:	9781109577433

Impact of continuity of care and provider factors on medication adherence in patients with hypertension.
Shermock, Kenneth M.

Impact of continuity of care and provider factors on medication adherence in patients with hypertension. - 160 p.

Source: Dissertation Abstracts International, Volume: 71-01, Section: B, page: 2630.

Thesis (Ph.D.)--The Johns Hopkins University, 2009.

Statement of the problem. Hypertension is one of the most common and deadly chronic diseases in the United States today. Despite the fact that medications are readily available that can control high blood pressure, less than 25% of people who are diagnosed have adequate control. Nonadherence to prescribed antihypertensive medication regimens plays a major role in this avoidable morbidity and mortality. The primary goal of this dissertation is to assess understudied factors that may be related to adherence to antihypertensive medications.

ISBN: 9781109577433Subjects--Topical Terms:

1017659
Health Sciences, Public Health.

Impact of continuity of care and provider factors on medication adherence in patients with hypertension.
LDR:03304nam a2200325 4500 001 1967958
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020 $a 9781109577433
035 $a (MiAaPQ)AAI3392383
035 $a AAI3392383
040 $a MiAaPQ $c MiAaPQ
100 1 $a Shermock, Kenneth M. $3 2105055
245 1 0 $a Impact of continuity of care and provider factors on medication adherence in patients with hypertension.
300 $a 160 p.
500 $a Source: Dissertation Abstracts International, Volume: 71-01, Section: B, page: 2630.
500 $a Adviser: Jonathan Weiner.
502 $a Thesis (Ph.D.)--The Johns Hopkins University, 2009.
520 $a Statement of the problem. Hypertension is one of the most common and deadly chronic diseases in the United States today. Despite the fact that medications are readily available that can control high blood pressure, less than 25% of people who are diagnosed have adequate control. Nonadherence to prescribed antihypertensive medication regimens plays a major role in this avoidable morbidity and mortality. The primary goal of this dissertation is to assess understudied factors that may be related to adherence to antihypertensive medications.
520 $a Objectives. This study assessed the relationship between continuity of care, the mix of provider types involved in care, and morbidity burden on adherence to antihypertensive regimens.
520 $a Methods. This was a retrospective observational study using longitudinal medical and pharmaceutical claims data from the PharMetrics Integrated Outcomes Database. Patients included in this analysis had a medical claim with a diagnosis of hypertension and received at least one prescription for an antihypertensive medication. The relationship between adherence and the dependent and control variables was assessed using multivariate proportional odds models.
520 $a Results. A total of 2,432 patients were included in the analysis. There was no significant relationship detected between continuity of care and adherence. Compared to patients who only saw specialist providers, patients had higher odds of poor adherence if they only saw primary care providers (OR: 1.5, 95% CI: 1.0--2.2) or if they saw both types of providers (OR: 1.4, 95% CI: 1.1--1.9). Patients with the highest level of morbidity had decreased odds of having good adherence (OR: 0.7, 95% CI: 0.5--0.9).
520 $a Conclusions. The results suggest there is no relationship between continuity of care and adherence and patients with a primary care provider or a higher morbidity burden experience worse adherence. However, the results should be interpreted with caution. The measure of continuity of care used in this study does not assess the quality of the relationship between patient and provider. Additionally, the type of managed care services, extent of automatic refills, or racial and socioeconomic status of the patients are not included. These variables, if available, might help to explain the unexpected results observed in this study.
590 $a School code: 0098.
650 4 $a Health Sciences, Public Health. $3 1017659
650 4 $a Health Sciences, Pharmacy. $3 1017737
690 $a 0573
690 $a 0572
710 2 $a The Johns Hopkins University. $3 1017431
773 0 $t Dissertation Abstracts International $g 71-01B.
790 $a 0098
791 $a Ph.D.
792 $a 2009
793 $a English
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3392383