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Poor Medication Adherence in African Americans Is a Matter of Trust

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Abstract

The purpose of this paper was to explore the lack of medication adherence in the African American patient community. The paper will address myths that many African American patients believe related to type 2 diabetes, hypertension treatment, and natural remedies. Research has shown that the disparities in the acceptance of healthcare provider advice and prescriptions are a significant concern particularly in African American patients. The acceptance of a provider’s diagnosis and subsequent intervention can vary based on several issues including healthcare access, patient preferences, trust of a provider, and treatment recommendations. Patient influences can range from their ability to trust the provider (and what he/she says) to following through with their advice. Several studies have looked at the beliefs and misconceptions some African Americans hold regarding the treatment of hypertension and diabetes with some showing a preference for “natural remedies.” This paper will leverage a literature review to seek out myths from African American patients to understand why they are dealing with challenges related to adherence with medication. The searches identified 58 research papers. The study applied an inductive content analysis approach to assess the research papers and identify themes. The barriers identified in this study include disbelief of the diagnosis, distrust for medication, mistrust for physicians and healthcare system, belief in alternative medicine, cultural/generation norms, and access/affordability of care. One of the most prominent factors that crossed all barriers was medical mistrust.

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References

  1. Williams DR, Sternthal M. Understanding racial-ethnic disparities in health: sociological contributions. J Health Soc Behav. 2010;51(1_suppl):S15–27.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Copeland VC. African Americans: disparities in health care access and utilization. Health Soc Work. 2005;30(3):265–70.

    Article  PubMed  Google Scholar 

  3. Assari S. Health disparities due to diminished return among black Americans: public policy solutions. Soc Is sues Policy Rev. 2018;12(1):112–45.

    Article  Google Scholar 

  4. Barr DA. Health disparities in the United States: social class, race, ethnicity, and the social determinants of health. Baltimore: JHU Press; 2014.

    Google Scholar 

  5. Mead N, Bower P. Patient-centredness: a conceptual framework and review of the empirical literature. Soc Sci Med. 2000;51(7):1087–110.

    Article  CAS  PubMed  Google Scholar 

  6. Center for Disease Control and Prevention. U.S. Public Health Service Syphilis Study at Tuskegee. https://www.cdc.gov/tuskegee/index.html. Accessed 1 Aug 2020.

  7. Ojanuga D. The medical ethics of the “father of gynaecology”, Dr J Marion Sims. J Med Ethics. 1993;19(1):28–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Washington HA. Medical apartheid: the dark history of medical experimentation on black Americans from colonial times to the present. Doubleday Books. 2006

  9. Matthew DB. Just medicine: a cure for racial inequality in American healthcare. New York: NYU Press; 2018.

    Google Scholar 

  10. Chetty R, Stepner M, Abraham S, Lin S, Scuderi B, Turner N, et al. The association between income and life expectancy in the United States, 2001-2014. JAMA. 2016;315(16):1750–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Masharani U, Sherchan P, Schloetter M, Stratford S, Xiao A, Sebastian A, et al. Metabolic and physiologic effects from consuming a hunter-gatherer (Paleolithic)-type diet in type 2 diabetes. Eur J Clin Nutr. 2015;69(8):944–8.

    Article  CAS  PubMed  Google Scholar 

  12. US Department of Health and Human Services Office of Minority Health. Minority Health. Retrieved from https://www.minorityhealth.hhs.gov. Accessed 1 Aug 2020.

  13. Fineberg D, Jandeleit-Dahm KA, Cooper ME. Diabetic nephropathy: diagnosis and treatment. Nat Rev Endocrinol. 2013;9(12):713–23.

    Article  CAS  PubMed  Google Scholar 

  14. Thomas SJ, Booth JN III, Dai C, Li X, Allen N, Calhoun D, et al. Cumulative incidence of hypertension by 55 years of age in blacks and whites: the CARDIA study. J Am Heart Assoc. 2018;7(14):e007988 1–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Guerrero-García C, Rubio-Guerra AF. Combination therapy in the treatment of hypertension. Drugs Context. 2018;7:1–9.

    Article  Google Scholar 

  16. Cuevas AG, O'Brien K, Saha S. African American experiences in healthcare: “I always feel like I’m getting skipped over”. Health Psychol. 2016;35(9):987–95.

    Article  PubMed  Google Scholar 

  17. Khatib R, Schwalm JD, Yusuf S, Haynes RB, McKee M, Khan M, et al. Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: a systematic review and meta-analysis of qualitative and quantitative studies. PLoS One. 2014;9(1):1–12.

    Article  CAS  Google Scholar 

  18. McQuaid EL, Landier W. Cultural issues in medication adherence: disparities and directions. J Gen Intern Med. 2018;33(2):200–6.

    Article  PubMed  Google Scholar 

  19. Hatcher E, Whittemore R. Hispanic adults’ beliefs about type 2 diabetes: clinical implications. J Am Acad Nurse Pract. 2007;19(10):536–45.

    Article  PubMed  Google Scholar 

  20. Nam S, Chesla C, Stotts NA, Kroon L, Janson SL. Barriers to diabetes management: patient and provider factors. Diabetes Res Clin Pract. 2011;93(1):1–9.

    Article  PubMed  Google Scholar 

  21. Shiyanbola OO, Brown CM, Ward EC. “I did not want to take that medicine”: African-Americans’ reasons for diabetes medication nonadherence and perceived solutions for enhancing adherence. Patient Preference Adherence. 2018;12:409–12.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ndumele CD, Shaykevich S, Williams D, Hicks LS. Disparities in adherence to hypertensive care in urban ambulatory settings. J Health Care Poor Underserved. 2010;21(1):132–43.

    Article  PubMed  Google Scholar 

  23. Lewis LM, Ogedegbe C, Ogedegbe G. Enhancing adherence of antihypertensive regimens in hypertensive African Americans: current and future prospects. Expert Rev Cardiovasc Ther. 2012;10(11):1375–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Lukoschek P. African Americans’ beliefs and attitudes regarding hypertension and its treatment: a qualitative study. J Health Care Poor Underserved. 2003;14(4):566–87.

    Article  PubMed  Google Scholar 

  25. Dickson VV, McCarthy MM, Howe A, Schipper J, Katz SM. Sociocultural influences on heart failure self-care among an ethnic minority black population. J Cardiovasc Nurs. 2013;28(2):111–8.

    Article  PubMed  Google Scholar 

  26. Ciechanowski PS, Katon WJ, Russo JE, Walker EA. The patient-provider relationship: attachment theory and adherence to treatment in diabetes. Am J Psychiatr. 2001;158(1):29–35.

    Article  CAS  PubMed  Google Scholar 

  27. Rucker-Whitaker C, Flynn KJ, Kravitz G, Eaton C, Calvin JE, Powell LH. Understanding African-American participation in a behavioral intervention: results from focus groups. Contemp Clin Trials. 2006;27(3):274–86.

    Article  PubMed  Google Scholar 

  28. Brown MT, Bussell J, Dutta S, Davis K, Strong S, Mathew S. Medication adherence: truth and consequences. Am J Med Sci. 2016;351(4):387–99.

    Article  PubMed  Google Scholar 

  29. World Health Organization (2020) Adherence to Long-Term Therapies. https://www.who.int/chp/knowledge/publications/adherence_full_report.pdf. Accessed 1 Aug 2020.

  30. Berelson B. Content analysis in communication research. New York: Free Press; 1952.

    Google Scholar 

  31. Krippendorff K. Content analysis: an introduction to its methodology. Thousand Oaks: Sage Publications; 2018.

    Google Scholar 

  32. Cronin P, Ryan F, Coughlan M. Undertaking a literature review: a step-by-step approach. Br J Nurs. 2008;17(1):38–43.

    Article  PubMed  Google Scholar 

  33. Jordanova L. The social construction of medical knowledge. Soc Hist Med. 1995;8(3):361–81.

    Article  CAS  PubMed  Google Scholar 

  34. Hogan VK, Rowley D, Bennett T, Taylor KD. Life course, social determinants, and health inequities: toward a national plan for achieving health equity for African American infants—a concept paper. Matern Child Health J. 2012;16(6):1143–50.

    Article  PubMed  Google Scholar 

  35. Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4–7 yr before clinical diagnosis. Diabetes Care. 1992;15(7):815–9.

    Article  CAS  PubMed  Google Scholar 

  36. Rhee MK, Ho YL, Raghavan S, Vassy JL, Cho K, Gagnon D, et al. Random plasma glucose predicts the diagnosis of diabetes. PLoS One. 2019;14(7):1–13.

    Article  CAS  Google Scholar 

  37. Jacobs EA, Rolle I, Ferrans CE, Whitaker EE, Warnecke RB. Understanding African Americans’ views of the trustworthiness of physicians. J Gen Intern Med. 2006;21(6):642–7.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Savoca MR, Arcury TA, Leng X, Bell RA, Chen H, Anderson A, et al. The diet quality of rural older adults in the south as measured by healthy eating index-2005 varies by ethnicity. J Am Diet Assoc. 2009;109(12):2063–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Chapman EN, Kaatz A, Carnes M. Physicians and implicit bias: how doctors may unwittingly perpetuate healthcare disparities. J Gen Intern Med. 2013;28(11):1504–10.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Williams DR, Neighbors HW, Jackson JS. Racial/ethnic discrimination and health: findings from community studies. Am J Public Health. 2003;93(2):200–8.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Holt CL, McClure SM. Perceptions of the religion-health connection among African American church members. Qual Health Res. 2006;16(2):268–81.

    Article  PubMed  Google Scholar 

  42. Kronish IM, Leventhal H, Horowitz CR. Understanding minority patients’ beliefs about hypertension to reduce gaps in communication between patients and clinicians. The Journal of Clinical Hypertension. 2012;14(1):38–44.

    Article  PubMed  Google Scholar 

  43. Engel KG, Heisler M, Smith DM, Robinson CH, Forman JH, Ubel PA. Patient comprehension of emergency department care and instructions: are patients aware of when they do not understand? Ann Emerg Med. 2009;53(4):454–61.

    Article  PubMed  Google Scholar 

  44. Schoenfeld EM, Goff SL, Downs G, Wenger RJ, Lindenauer PK, Mazor KM. A qualitative analysis of patients’ perceptions of shared decision making in the emergency department: “let me know I have a choice”. Acad Emerg Med. 2018;25(7):716–27.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Becker G, Gates RJ, Newsom E. Self-care among chronically ill African Americans: culture, health disparities, and health insurance status. Am J Public Health. 2004;94(12):2066–73.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Skirbekk H, Middelthon AL, Hjortdahl P, Finset A. Mandates of trust in the doctor–patient relationship. Qual Health Res. 2011;21(9):1182–90.

    Article  PubMed  Google Scholar 

  47. Aikens JE, Piette JD. Diabetic patients’ medication underuse, illness outcomes, and beliefs about antihyperglycemic and antihypertensive treatments. Diabetes Care. 2009;32(1):19–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Buckley L, Labonville S, Barr J. A systematic review of beliefs about hypertension and its treatment among African Americans. Curr Hypertens Rep. 2016;18(7):52 1–9.

    Article  PubMed  CAS  Google Scholar 

  49. Bockwoldt D, Staffileno BA, Coke L, Hamilton R, Fogg L, Calvin D, et al. Understanding experiences of diabetes medications among African Americans living with type 2 diabetes. J Transcult Nurs. 2017;28(4):363–71.

    Article  PubMed  Google Scholar 

  50. Thom DH. Physician behaviors that predict patient trust. J Fam Pract. 2001;50(4):323–4.

    CAS  PubMed  Google Scholar 

  51. Thom DH, Kravitz RL, Bell RA, Krupat E, Azari R. Patient trust in the physician: relationship to patient requests. Fam Pract. 2002;19(5):476–83.

    Article  PubMed  Google Scholar 

  52. Cuffee YL, Hargraves JL, Rosal M, Briesacher BA, Schoenthaler A, Person S, et al. Reported racial discrimination, trust in physicians, and medication adherence among inner-city African Americans with hypertension. Am J Public Health. 2013;103(11):e55–62.

    Article  PubMed  PubMed Central  Google Scholar 

  53. LoCurto J, Berg GM. Trust in healthcare settings: scale development, methods, and preliminary determinants. SAGE Open Med. 2016;4:2050312116664224 1–12.

    Article  PubMed  PubMed Central  Google Scholar 

  54. McKee D, Fletcher J. Primary care for urban adolescent girls from ethnically diverse populations: foregone care and access to confidential care. J Health Care Poor Underserved. 2006;17(4):759–74.

    Article  PubMed  Google Scholar 

  55. Armstrong K, Ravenell KL, McMurphy S, Putt M. Racial/ethnic differences in physician distrust in the United States. Am J Public Health. 2007;97(7):1283–9.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Lorié Á, Reinero DA, Phillips M, Zhang L, Riess H. Culture and nonverbal expressions of empathy in clinical settings: a systematic review. Patient Educ Couns. 2017;100(3):411–24.

    Article  PubMed  Google Scholar 

  57. Eiser AR, Ellis G. Cultural competence and the African American experience with health care: the case for specific content in cross-cultural education. Acad Med. 2007;82(2):176–83.

    Article  PubMed  Google Scholar 

  58. Boyd EL, Taylor SD, Shimp LA, Semler CR. An assessment of home remedy use by African Americans. J Natl Med Assoc. 2000;92(7):341–53.

    CAS  PubMed  PubMed Central  Google Scholar 

  59. Gopal J, Anthonydhason V, Muthu M, Gansukh E, Jung S, Chul S, et al. Authenticating apple cider vinegar’s home remedy claims: antibacterial, antifungal, antiviral properties and cytotoxicity aspect. Nat Prod Res. 2019;33(6):906–10.

    Article  CAS  PubMed  Google Scholar 

  60. Avenues of growth in apple cider vinegar market go beyond the health & wellness trend. 2020. Retrieved from https://www.transparencymarketresearch.com/apple-cider-vinegar-market.html. Accessed 1 Aug 2020.

  61. Tkachenko N, Chotvijit S, Gupta N, Bradley E, Gilks C, Guo W, et al. Google trends can improve surveillance of type 2 diabetes. Sci Rep. 2017;7(1):1–10.

    Article  CAS  Google Scholar 

  62. Complementary & Alternative Medicine Market Worth $210.81 Billion By 2026. 2019. Retrieved from https://www.grandviewresearch.com/press-release/global-alternative-complementary-medicine-therapies-market. Accessed 1 Aug 2020.

  63. Center for disease for vital signs: racial disparities in age-specific mortality among Blacks or African Americans — United States. https://www.cdc.gov/mmwr/volumes/66/wr/mm6617e1.htm. Accessed 1 Aug 2020.

  64. Baer HA. The limited empowerment of women in black spiritual churches: an alternative vehicle to religious leadership. Sociol Relig. 1993;54(1):65–82.

    Article  Google Scholar 

  65. Whaley AL. Cultural mistrust: an important psychological construct for diagnosis and treatment of African Americans. Prof Psychol Res Pract. 2001;32(6):555–62.

    Article  Google Scholar 

  66. White RM. Unraveling the Tuskegee study of untreated syphilis. Arch Intern Med. 2000;160(5):585–98.

    Article  CAS  PubMed  Google Scholar 

  67. Happe LE, Clark D, Holliday E, Young T. A systematic literature review assessing the directional impact of managed care formulary restrictions on medication adherence, clinical outcomes, economic outcomes, and healthcare resource utilization. J Manag Care Pharm. 2014;20(7):677–84.

    Article  Google Scholar 

  68. Simoens S, Sinnaeve PR. Patient co-payment and adherence to statins: a review and case studies. Cardiovasc Drugs Ther. 2014;28(1):99–109.

    Article  CAS  PubMed  Google Scholar 

  69. Munshi KD, Mager D, Ward KM, Mischel B, Henderson RR. The effect of Florida Medicaid’s state-mandated formulary provision on prescription drug use and health plan costs in a Medicaid managed care plan. J Manag Care Spec Pharm. 2018;24(2):124–31.

    PubMed  Google Scholar 

  70. Kesselheim AS, Wang B, Franklin JM, Darrow JJ. Trends in utilization of FDA expedited drug development and approval programs, 1987-2014: cohort study. BMJ. 2015;351(h4633):1–7.

    Google Scholar 

  71. Zuvekas SH. Financing of behavioral health services: insurance, managed care, and reimbursement. In: Foundations of Behavioral Health. Cham: Springer; 2020. p. 71–99.

    Chapter  Google Scholar 

  72. Hall G. Patient-centered clinical care for African Americans. New York: Springer; 2020.

    Book  Google Scholar 

  73. Ngoh LN. Health literacy: a barrier to pharmacist–patient communication and medication adherence. J Am Pharm Assoc. 2009;49(5):e132–49.

    Article  Google Scholar 

  74. Sokol MC, McGuigan KA, Verbrugge RR, Epstein RS. Impact of medication adherence on hospitalization risk and healthcare cost. Med Care. 2005;43:521–30.

    Article  PubMed  Google Scholar 

  75. Müller S, Kohlmann T, Wilke T. Validation of the adherence barriers questionnaire–an instrument for identifying potential risk factors associated with medication-related non-adherence. BMC Health Serv Res. 2015;15(1):153 1–12.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Soto-Greene ML, Salas-Lopez D, Sanchez J, Like RC. Antecedents to effective treatment of hypertension in Hispanic populations. Clin Cornerstone. 2004;6(3):30–8.

    Article  PubMed  Google Scholar 

  77. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353(5):487–97.

    Article  CAS  PubMed  Google Scholar 

  78. Ferdinand KC, Yadav K, Nasser SA, Clayton-Jeter HD, Lewin J, Cryer DR, et al. Disparities in hypertension and cardiovascular disease in blacks: the critical role of medication adherence. J Clin Hypertens. 2017;19(10):1015–24.

    Article  Google Scholar 

  79. Stanley SJ, Chatham AP, Trivedi N, Aldoory L. Communication and control: hearing the voices of low-income African American adults to improve relationships with healthcare providers. Health Commun. 2019:1–10.

  80. Van Ryn M, Fu SS. Paved with good intentions: do public health and human service providers contribute to racial/ethnic disparities in health? Am J Public Health. 2003;93(2):248–55.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Burgess D, Van Ryn M, Dovidio J, Saha S. Reducing racial bias among health care providers: lessons from social-cognitive psychology. J Gen Intern Med. 2007;22(6):882–7.

    Article  PubMed  PubMed Central  Google Scholar 

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  1. Northeast Ohio Medical University College of Medicine, 464 Richmond Road, Suite 201, Richmond Heights, OH, 44143, USA

    Gregory L. Hall

  2. Cleveland State University, 1860 E. 18th Street, BU 440, Cleveland, OH, 44114, USA

    Michele Heath

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Hall, G.L., Heath, M. Poor Medication Adherence in African Americans Is a Matter of Trust. J. Racial and Ethnic Health Disparities 8, 927–942 (2021). https://doi.org/10.1007/s40615-020-00850-3

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