Provider communication effects medication adherence in hypertensive African Americans

Patient Educ Couns. 2009 May;75(2):185-91. doi: 10.1016/j.pec.2008.09.018. Epub 2008 Nov 14.


Objective: To evaluate the effect of patients' perceptions of providers' communication on medication adherence in hypertensive African Americans.

Methods: Cross-sectional study of 439 patients with poorly controlled hypertension followed in community-based healthcare practices in the New York metropolitan area. Patients' rating of their providers' communication was assessed with a perceived communication style questionnaire,while medication adherence was assessed with the Morisky self-report measure.

Results: Majority of participants were female, low-income, and had high school level educations, with mean age of 58 years. Fifty-five percent reported being nonadherent with their medications; and 51% rated their provider's communication to be non-collaborative. In multivariate analysis adjusted for patient demographics and covariates (depressive symptoms, provider degree), communication rated as collaborative was associated with better medication adherence (beta=-.11, p=.03). Other significant correlates of medication adherence independent of perceived communication were age (beta=.13, p=.02) and depressive symptoms (beta=-.18, p=.001).

Conclusion: Provider communication rated as more collaborative was associated with better adherence to antihypertensive medications in a sample of low-income hypertensive African-American patients.

Practice implications: The quality of patient-provider communication is a potentially modifiable element of the medical relationship that may affect health outcomes in this high-risk patient population.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • African Americans* / psychology
  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Linear Models
  • Male
  • Medication Adherence*
  • Middle Aged
  • Multivariate Analysis
  • New York City
  • Physician-Patient Relations*
  • Poverty


  • Antihypertensive Agents