Patient trust in physicians and adoption of lifestyle behaviors to control high blood pressure

Abstract

Objective: To assess the relationship between patients' trust in their physician and self-reported adoption of lifestyle modification behaviors and medication adherence for control of hypertension.

Methods: Longitudinal analysis of data from a randomized controlled trial of interventions to enhance hypertensive patients' adherence to medications and recommended lifestyle modifications. Two hundred patients were seen by 41 physicians at 14 urban primary care practices in Baltimore, Maryland, and followed for 12 months.

Results: Seventy percent of patients reported complete trust in their physician. In adjusted analyses, patients with complete trust had higher odds of reporting that they were trying to lose weight (OR=2.27, 95% CI=1.38-3.74) than did patients with less than complete trust in their physician. Though not statistically significant, the odds of reporting trying to cut back on salt and engaging in regular exercise were greater in patients with complete trust. We observed no association for reports of medication adherence.

Conclusion: Trust in one's physician predicts attempts to lose weight among patients with hypertension, and may contribute to attempts to reduce salt and increase exercise.

Practice implications: Strengthening patient-physician relationships through efforts to enhance trust may be a promising strategy to enhance patients' engagement in healthy lifestyle behaviors for hypertension.