Matrix: Non-Adherence among Hypertensive African American Males

Matrix: Non-Adherence among Hypertensive African American Males
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Adherence remains a pertinent issue in the management of hypertensive African American males (Ogedegbe, 2009). A search was conducted to identify articles relevant to the problem of non-adherence among hypertensive African Americans. The keywords for the search were “adherence”, “African American male,” and “hypertension mobile app.” The keywords were deemed appropriate in addressing the subject matter, and would thus yield more search results. The keywords were combined using operators “AND or OR”, in order to increase the search yield. The paper searched the electronic databases (PROQUEST, University of Phoenix online lib, EBSCohost). The databases were chosen because they are easily accessible. The abstracts and titles were checked for relevance. The references of the searched articles were checked in order to uncover more articles. Only English and full text articles were considered for this paper. Quantitative, qualitative and systematic reviews were the only one considered for this paper. Articles were included if they addressed the problem of hypertension treatment adherence (most importantly African Americans) and those that addressed use of devices in improving adherence to hypertension treatment. Articles were included if they were published during or after the year 2000. After subjecting the articles to the inclusion criteria, five articles were deemed relevant. These include: Marshall, Wolfe and McKevitt, 2012; Ogedegbe et al. 2003; Rose et al., 2000; Christensen et al., 2009; and Fongwa et al., 2008. The articles were chosen as they elaborately and concisely address the issue of adherence to hypertension medication among African American males, and the usefulness and applicability of devices in addressing the issue. Mobile apps provide a novel intervention for addressing adherence in the management of chronic diseases (Labow, 2011; Phillips et al., 2013; Reach, 2009). In addition, they are published in peer reviewed journals, ensuring credibility of information therein. Some of the studies chosen also address intersectional collaboration between professional care providers with regard to adherence of hypertensive medications. As such, studies chosen have a variation among the participants with regards to workplaces and professions in order to represent the different types of practices with regards to hypertensive medication adherence (Adebayo & Antoinette, 2010).
Matrix Table
Source Citation

Purpose/Problem

Design/Sample

Instruments/Measures
[Include Reliability/Validity]

Results
[Include actual data]

Strengths/Weaknesses

Marshall, I.J., Wolfe, D. & McKevitt, C. (2012). Lay perspectives on hypertension and drug adherence:
systematic review of qualitative research. BMJ 344, 3-16.

To understand the perspective of patients with regards to hypertension and drug taking.
To investigate how these perspectives vary among different ethnic groups and cultures.

Systematic review
Electronic databases searched (Medline, British Nursing Index, Embase, PsycInfo and Social Policy and Practice).

The quality of searched papers checked using a checklist by Dixon-Woods et al.
The quality of each paper was checked by one reviewer.
A sensitivity analysis was done by reanalyzing data to check for bias.

53 qualitative studies synthesized. Many participants thought hypertension was caused by stress. Participants intentionally stopped or reduced treatment without consulting the doctor.
Most participants thought that they did not need treatment when their symptoms had improved, or when they were not stressed.
Participants disliked hypertension medication and its side effects and feared development of addiction.
Participants noted external factors preventing adherence (lack of money for drugs and food; lack of insurance; forgetfullness)

Strength: study synthesizes many qualitative studies from different countries; hence robustness of study
Only peer reviewed journals used
Weakness: Certain groups represented disproportionately where most studies reviewed focused on ethnic minority.

Ogedegbe, G., Mancuso, A., Allegrante, J. P. & Charlson, M. E. (2003). Development and evaluation of medication adherence self-efficacy
scale in hypertensive African-American patients. Journal of Clinical Epidemiology 56, 520-529.

To develop and evaluate a treatment adherence self-efficacy scale in hypertensive African Americans in an urban primary care setting.

Qualitative study in two phases.
A convenience sample of 106 hypertensive African American patients.
Phase I:- qualitative item generation phase (draft survey)
Phase II:-Item testing phase.

A 43-item draft self-efficacy questionnaire used.
Two forms of reliability assessed: test-retest reliability and internal consistency.
Internal consistency evaluated by cronbach's alpha coefficient (>0.5).
Test-retest analyses done with kappa statistics (>0.4)

From the results, a 26-item questionnaire was developed.
The tool measures situation-specific efficacy beliefs pertaining to medication adherence in a high risk population.
The results of Ogedegbe et al. suggest that the tool is stable, internally consistent and reliable measure of self-efficacy.
The tool can be utilized during primary care and research settings.

Strength: The t...