Medication Among Adult African Americans With Hypertension In S.Central US Project Papers.

Medication Among Adult African Americans With Hypertension In S.Central US Project Papers.

In the United States, it has been recognized that one of every four medical visits results from patients not following the advice they were given, and non-adherence constitutes 33% – 69% of medication-related hospital admissions each year (Scott & McClure, 2010).  Similarly, annual deaths due to non-adherence to medication in the United States are estimated at 125,000, and non-adherence to medication also costs an estimated $100 billion annually in both direct and indirect healthcare costs (Scott, & McClure, 2010).  These facts are substantiated by Elliot (2003) who identified that non-adherence to prescribed medication and insufficiently intensive treatment as the two challenging obstacles to control high blood pressure.  Medication Among Adult African Americans With Hypertension In S.Central US Project Papers.

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Existing literature cites non-adherence to prescribed medication and insufficiently intensive treatment (treatment that is not enough to remediate or control a condition) as the two challenging obstacles to controlling high blood pressure (Solomon et al. 2015).  Even though African Americans (AAs) constitute about 12.8% of the entire United States population, AAs have the highest rate of hypertension (over 38%) compared to other ethnic groups (Ferdinand & Saunders, 2006; Flávio, 2011).  According to Rigsby (2011), African Americans have an earlier age of onset of hypertension increased incidence and prevalence of hypertension; and high hypertension-related morbidity, including mortality rates.  Based on the existing facts that AAs are susceptible to high incidences of hypertension due to their genetic heritage, low literacy, and socioeconomic status which are associated to medication adherence, it becomes imperative to develop a staff education manual.  The staff education training module guided by the Walden University staff education manual will thus assist the facility to provide quality health education programs to help improve hypertension medication adherence among AAs. Medication Among Adult African Americans With Hypertension In S.Central US Project Papers.

The DNP student will adopt the Walden staff education manual in developing training that includes medication adherence evidence-based materials.  This approach will in turn expected to reduce the incidence of hypertension within the AA population.  Staff education manuals which emphasize behavioral interventions and increased adherence to recommended pharmacological treatments and lifestyle changes have been proposed as intervention strategies (Gross, Anderson, Busby, Erith, & Panco 2013).

According to Healthy Paso Del Notre (2017), the percentage of Medicare beneficiaries who were treated for hypertension in 2015 for El Paso County, Texas was 53.7%.  African Americans constitute 3.97% of the entire El Paso County (Healthy Paso Del Notre, 2017). El Paso County has the highest percentage (24%) of adults not taking hypertension medication as prescribed compared to Texas (22%) and the US (21%) respectively (City of El Paso Department of Public Health, 2013). Medication Among Adult African Americans With Hypertension In S.Central US Project Papers.

The purpose of this capstone project is to utilize evidence-based clinical practice to develop a staff education manual which can properly guide staff of the facility to educate AA patients with hypertension.  The objective is to cultivate the culture of adhering to their medications among the AAs and thereby increasing the goal of achieving improved hypertension medication adherence (HMA) among AA population.

Practice-Focused Question(s)

“Does the literature support the use of a staff education manual in developing education module that can improve medication adherence in AAs patients 21 to 85 years of age with uncontrolled hypertension (HTN, BP > 140/90)?”

“Is literacy a hindrance

Social Change

AAs are known to suffer a disproportionately large burden of cardiovascular morbidity and mortality in the United States compared to other ethnic groups (Bosworth et al. 2008).  Based on this, it is indicated that half of the cardiovascular mortality disparity between AAs and other ethnic groups is directly attributable to hypertension (Bosworth et al. 2008).  In this regard, medication nonadherence is of particular interest because it is recognized as a potentially modifiable factor that might be used to reduce this unusual disparity in hypertension control among AAs. Medication Among Adult African Americans With Hypertension In S.Central US Project Papers.

Most evidence-based research literature of hypertension treatment cite nonadherence to prescribed medication and insufficiently intensive treatment as the two challenging obstacles to controlling high blood pressure (Elliott, 2003). According to Gross et al. (2013), evidence-based research literature emphasized that educational program that focused on behavioral interventions increased adherence to recommended pharmacological treatments and lifestyle changes.

The United States population has become cosmopolitan and diversified to the extent that any intervention to address a chronic medical issue, such as hypertension medication adherence,  requires an individualized, culturally sensitive approach that aligns with the assessment of patients’ beliefs, knowledge, and health habits (Lakshman et al. 2014).  The MAAAA project is designed to promote patients’ awareness of their adherence patterns, which can change their behavior and remain the key elements to changing patients’ behavior such as education, motivation, and measurement (Vrijens et al. 2017)   Medication Among Adult African Americans With Hypertension In S.Central US Project Papers.

In the South Central United States, it has been recognized that one of every four medical visits results in patients not following the advice they were given, and nonadherence contributes between 33% and 69% of medication-related hospital admissions each year (Scott, & McClure, 2010).  Similarly, annual deaths due to nonadherence to medication in the United States are estimated at 125,000 deaths, and nonadherence to medication also costs an estimated $100 billion annually in both direct and indirect healthcare costs (Scott, & McClure, 2010) and AAs particularly those in South Central United States bear huge chunk of these adverse impacts.  The implication is that these factors impose a substantial burden on the healthcare system and, therefore, call for the identification of viable alternatives to our society’s heavy reliance on medications (Lauzière et al. 2013).  Previous studies on the use of education programs for hypertension medication suggested that the implementation of educational programs included benefits due to the reduction of costs related to treatments. Medication Among Adult African Americans With Hypertension In S.Central US Project Papers.

Also, Lauzière et al. (2013) reported the effects of educational programs on HTN that demonstrated the reduction in BP among participants from previous studies.  The beauty of the staff education manual is that the facility will use a structured educational program that will be more efficient to increase patients’ knowledge on HTN medication adherence compared to the usual approaches of counseling at the bedside or in the office

Diligent implementation of patient-centered education proposed by the staff education manual for this project should enhance medication adherence to hypertension disease prevention and management programs in low-income populations such as the AAs and may be replicated to other vulnerable ethnic populations.

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Medication Among Adult African Americans With Hypertension In S.Central US Project Papers.