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Self-care management strategies used by Black women who self-report consistent adherence to antihypertensive medication

Authors Abel WM, Joyner JS, Cornelius JB, Greer DB

Received 28 March 2017

Accepted for publication 4 July 2017

Published 16 August 2017 Volume 2017:11 Pages 1401—1412

DOI https://doi.org/10.2147/PPA.S138162

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Dr Johnny Chen

Willie M Abel,1 Jessica S Joyner,2 Judith B Cornelius,1 Danice B Greer3

1School of Nursing, The University of North Carolina at Charlotte, Charlotte, NC, USA; 2Internal Medicine, Novant Health First Charlotte Physicians, Matthews, NC, USA; 3School of Nursing, The University of Texas at Tyler, Tyler, TX, USA

Background: Black women in the USA have the highest prevalence rate of hypertension (HTN) contributing to a higher risk of organ damage and death. Research has focused primarily on poorly controlled HTN, negative belief systems, and nonadherence factors that hinder blood pressure control. No known research studies underscore predominantly Black women who report consistent adherence to their antihypertensive medication-taking. The purpose of this study was to describe self-care management strategies used by Black women who self-report consistent adherence to their antihypertensive medication and to determine the existence of further participation in lifestyle modifications, such as eating a healthy diet and increasing physical activity.
Methods: Using a qualitative descriptive design, four focus groups with a total of 20 Black women aged 25–71 years were audio-taped. Transcripts were analyzed using qualitative content analysis. Participants were included in the study if they scored perfect adherence on the medication subscale of the Hill–Bone Compliance to High Blood Pressure Therapy Scale.
Results: Medication adherence was predicated on three themes: HTN experience, involvement with treatment regimen, and a strong motivated mentality. Black women would benefit from treatment approaches that are sensitive to 1) diverse emotional responses, knowledge levels, and life experiences; 2) two-way communication and trusting, collaborative relationships with active involvement in the treatment regimen; 3) lifestyle modifications that focus on health benefits and individual preferences; and 4) spiritual/religious influences on adherence.
Conclusion: The use of self-care management strategies to enhance antihypertensive medication adherence is key to adequate blood pressure control and the reduction of cardiovascular events. This study provides preliminary insight for future research to develop interventions to aid those Black women who struggle with medication adherence and are disproportionately impacted by HTN.

Keywords: hypertension, medication adherence, self-care management, qualitative focus groups, black women, healthy adherer effect

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