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RESEARCH REPORTS |
1 Postdoctoral Research Scientist, Department of Medicine, Columbia University College of
Physicians and Surgeons, Columbia University Medical Center, New York, NY
2 Assistant Professor of Medicine, Department of Medicine, Columbia University College of
Physicians and Surgeons, Columbia University Medical CenterJ
* To whom correspondence should be addressed. E-mail: ams2125{at}columbia.edu.
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Abstract |
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BACKGROUND: Electronic monitoring devices (EMDs) are regarded as the gold standard for assessing medication adherence in clinical research. However, little is known about the effect of patients' acceptance of EMDs on medication adherence in African Americans with hypertension who are followed in primary care practices
OBJECTIVE: To assess patients' perceptions of EMDs, their acceptance of EMDs, and the relationship of these perceptions to medication adherence in African Americans with hypertension who are followed in community-based practices.
METHODS: Patients were recruited from a larger randomized controlled trial assessing the effect of motivational interviewing on medication adherence and blood pressure in hypertensive African American patients followed in 2 New York City primary care practices. Medication adherence was assessed with a Medication Event Monitoring System (MEMS) during a 12-month monitoring period. At the 12-month follow-up, patients' perceptions of the MEMS were assessed with a 17-item questionnaire. ANOVA was used to compare patients' responses (agree, neither, disagree) with the MEMS adherence over the monitoring period. Tukey's post hoc tests were used to determine whether there were significant differences among the 3 groups.
RESULTS: Participants were predominantly women, low-income, unemployed, had a high school
education, and were a mean age of 53 years. Approximately two-thirds of the participants stated that the
MEMS helped them remember to take their medications, 93% reported that the MEMS was easy to open,
85% did not find it stressful, and 75% liked the MEMS and used it everyday. One-third of
patients preferred using a pillbox and 25% did not like traveling with the MEMS. Patients who
stated that they used the MEMS every day, felt comfortable using it in front of others, and remembered to
put refills in the MEMS had significantly better adherence over the study period than did those who
disagreed (p 
0.05).
CONCLUSIONS: African American patients treated for hypertension in community-based practices held positive perceptions about a MEMS. Perceptions about the practicality of a MEMS may yield important information about actual medication-taking behavior.
Key Words: adherence, African American, Medicaid, electronic monitoring devices, hypertension.
Reprints: Dr. Schoenthaler, Department of Medicine, Columbia University College of Physicians and Surgeons, Columbia University Medical Center, 622 W. 168th St., PH9 Center, Rm. 948, New York, NY 10032, fax 212/305-3172, ams2125@columbia.edu
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