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Wu JR, Cummings DM, Li Q, Hinderliter A, Bosworth HB, Tillman J, DeWalt D. The effect of a practice-based multicomponent intervention that includes health coaching on medication adherence and blood pressure control in rural primary care. Journal of clinical hypertension (Greenwich, Conn.). 2018 Apr 1; 20(4):757-764.
Low adherence to anti-hypertensive medications contributes to worse outcomes. The authors conducted a secondary data analysis to examine the effects of a health-coaching intervention on medication adherence and blood pressure (BP), and to explore whether changes in medication adherence over time were associated with changes in BP longitudinally in 477 patients with hypertension. Data regarding medication adherence and BP were collected at baseline, 6, 12, 18, and 24 months. The intervention resulted in increases in medication adherence (5.75?5.94, P = .04) and decreases in diastolic BP (81.6?76.1 mm Hg, P < .001) over time. The changes in medication adherence were associated with reductions in diastolic BP longitudinally (P = .047). Patients with low medication adherence at baseline had significantly greater improvement in medication adherence and BP over time than those with high medication adherence. The intervention demonstrated improvements in medication adherence and diastolic BP and offers promise as a clinically applicable intervention in rural primary care.