Source: Masters Abstracts International, Volume: 57-05.

Adviser: Melinda L. Irwin.

Background: Hispanics have a larger prevalence of uncontrolled hypertension (HTN) than non-Hispanic whites. Prior studies indicate increased physician follow-up can improve medication adherence and health outcomes.

Objective: Identify disparities in healthcare access among Hispanic adults with hypertension by anti-hypertension (anti-HTN) medication adherence status.

Methods: A total of 409 Hispanic adults (ages ≥18 years) with hypertension were included from the 2015 and 2016 Porter Novelli ESTILOS surveys. Nonadherence was defined as missing or skipping a dose of anti-HTN medication. The chi2 test was performed to examine the differences in non-adherence by selected characteristics, and multiple logistic regression was used to obtain the adjusted odds ratios after controlling for age, gender, income, education, insurance, and cost barrier to healthcare provider (HCP) access.

Results: Among respondents taking anti-HTN medication, nonadherence was significantly higher among those ages 18--34 (62.4%) years compared to those ages ≥ 55 years (15.7%; P=0.001). Nonadherence was also significantly higher among those who reported a cost barrier to seeing an HCP (63.6%) than those who did not report a financial barrier (11.7%; P=0.0003). Multiple logistic regression analyses showed that respondents who reported cost as a barrier were 13.3 (95%CI=4.1--42.7) times more likely to be nonadherent than those who did not report a cost barrier; all other factors were non-significant.

Conclusion/Public Health Implication: Cost of seeing an Health Care Provider was associated with anti-HTN medication nonadherence in Hispanic adults after controlling for sociodemographic and other healthcare access factors. Telemedicine could help improve medication adherence while reducing costs related barriers through increased physician follow-up in hypertension management.