Characteristics of diabetic patients associated with achieving and maintaining blood pressure targets in the Adherence and Intensification of Medications program.

Published

Journal Article

OBJECTIVES: To determine patient characteristics associated with achieving and sustaining blood pressure (BP) targets in the Adherence and Intensification of Medications program, a program led by pharmacists trained in motivational interviewing and authorized to make BP medication changes. METHODS: We conducted a retrospective cohort study of patients with diabetes and persistent hypertension in Kaiser Permanente and the Department of Veterans Affairs. Using two-level logistic regression, baseline survey data from 458 program participants were examined to determine patient characteristics associated with (1) discharge from the program with a target BP (short-term success) and (2) maintenance of the target BP over a nine-month period (long-term success). RESULTS: In multivariable analyses, patients who screened positive for depression or had a higher baseline systolic BP were less likely to achieve short-term success (adjusted odds ratio (AOR) 0.42 [95% confidence interval (CI): 0.19-0.93], p = 0.03; AOR 0.94 [0.91-0.97], p < 0.01; respectively). Patients who reported at baseline one or more barriers to medication adherence were less likely to achieve long-term success (AOR 0.50 [0.26-0.94], p = 0.03). CONCLUSIONS: Although almost 90% of patients achieved short-term success, only 28% achieved long-term success. Baseline barriers to adherence were associated with lack of long-term success and could be the target of maintenance programs for patients who achieve short-term success.

Full Text

Duke Authors

Cited Authors

  • Klamerus, ML; Kerr, EA; Bosworth, HB; Schmittdiel, JA; Heisler, M

Published Date

  • March 2014

Published In

Volume / Issue

  • 10 / 1

Start / End Page

  • 60 - 73

PubMed ID

  • 23892775

Pubmed Central ID

  • 23892775

Electronic International Standard Serial Number (EISSN)

  • 1745-9206

Digital Object Identifier (DOI)

  • 10.1177/1742395313496590

Language

  • eng

Conference Location

  • United States