First Things First: Difficulty with Current Medications Is Associated With Patient Willingness to Add New Ones.

The Patient
Brian J Zikmund-FisherEve A Kerr

Abstract

BACKGROUND: Inadequate blood pressure (BP) control remains prevalent. One proposed explanation is "clinical inertia," often defined as the failure by providers to initiate or intensify medication therapy when otherwise appropriate. However, patients could contribute to clinical inertia by signaling an unwillingness to consider medication intensification. OBJECTIVE: To explore covariates of patient attitudes regarding medication intensification. STUDY DESIGN: Cross-sectional survey. SETTING: 9 Midwestern U. S. Veterans' Administration medical facilities. PARTICIPANTS: 1,062 diabetics identified as having BP>= 140/90 mm Hg as part of a prospective cohort study of clinical inertia in hypertension treatment. MEASUREMENTS: Primary outcome was participants' indicated willingness to intensify BP medications if their provider noted elevated BP levels. Potential covariates assessed included BP control (actual and perceived), perceived importance of BP control, BP management self-efficacy, competing demands, medication factors (adherence and management issues), trust in provider, and sociodemographic factors. RESULTS: While 64% of participants reported complete willingness to intensify BP medications, 36% of participants expressed at lea...Continue Reading

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Jul 18, 2008·Primary Care Diabetes·Usha SubramanianE A Kerr

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Citations

Jan 5, 2012·Journal of General Internal Medicine·Neda LaiteerapongElbert S Huang
Feb 13, 2018·Current Medical Research and Opinion·Mark PeyrotGérard Reach

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