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Association Between Health Literacy and Medication Adherence Among Hispanics with Hypertension

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

A Correction to this article was published on 29 April 2019

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Abstract

Background

Poor adherence to prescribed antihypertensive medication is a major contributor to disparities in effective blood pressure control among Hispanics. The purpose of this study was to investigate the association between health literacy level and adherence to antihypertensive medications among Hispanic adults, who self-reported hypertension, controlling for potential covariates of adherence and/or health literacy.

Methods

We conducted a cross-sectional survey of 1355 Hispanic adults, primarily Dominicans, who self-reported hypertension. Antihypertensive medication adherence and health literacy were evaluated along with covariates, including sociodemographic characteristics, depression, anxiety, and sleep disturbance. Linear regression models were created for health literacy, each covariate, and adherence. Factors found to be significantly associated with adherence in the individual regression models at a p value of < 0.20 were included in a hierarchical multiple linear regression model.

Results

Overall, the majority of participants had low adherence levels to antihypertensive medications (88.4%; n = 1026) and inadequate health literacy (84.9%; n = 1151). When controlling for age, sex, birth country, education level, recruitment location, depression, anxiety, and sleep disturbance, having adequate as compared to inadequate health literacy was associated with a higher adherence score (b = 0.378, p = 0.043). The full model explained 13.6% of the variance in medication adherence (p value < 0.001), but the unique contribution of health literacy to the model was minimal (R2 change = 0.003).

Conclusions

Tailored interventions considering health literacy are needed to support medication adherence in order to improve hypertension outcomes of Hispanics. Additional studies are needed to identify and prioritize factors in the development of targeted and effective adherence interventions for Hispanics with hypertension.

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Change history

  • 29 April 2019

    Please note the following correction in the second paragraph of the Results section of this article, in the sentences that read, “Table 2 shows the association of health literacy level, as well as each of the included covariates with adherence.

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Funding

The Washington Heights/Inwood Informatics Infrastructure for Comparative Effectiveness Research was supported by R01HS019853 and R01HS022961. The analysis and manuscript preparation were supported by the Reducing Health Disparities Through Informatics training grant (T32NR007969) and the Precision in Symptom Self-Management (PriSSM) Center (P30NR016587). Dr. Koleck is also supported by K99NR017651 and Dr. Navarra by K23 NR015970.

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Authors and Affiliations

  1. School of Nursing, Columbia University, New York City, NY, USA

    Maichou Lor, Theresa A. Koleck, Suzanne Bakken & Sunmoo Yoon

  2. Biomedical Informatics, Columbia University, New York City, NY, USA

    Suzanne Bakken

  3. Data Science Institute, Columbia University, New York City, NY, USA

    Suzanne Bakken

  4. Rory Meyers College of Nursing, New York University, 433 First Avenue, New York City, NY, 10010, USA

    Ann-Margaret Dunn Navarra

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  1. Maichou Lor
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  2. Theresa A. Koleck
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  5. Ann-Margaret Dunn Navarra
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Correspondence to Ann-Margaret Dunn Navarra.

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The study received IRB approval from the Columbia University Medical Center’s Institutional Review Board. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Lor, M., Koleck, T.A., Bakken, S. et al. Association Between Health Literacy and Medication Adherence Among Hispanics with Hypertension. J. Racial and Ethnic Health Disparities 6, 517–524 (2019). https://doi.org/10.1007/s40615-018-00550-z

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