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Capstone

Hypertension Therapy Nonadherence Among Quileute Tribal Members

1 August 2005

Abstract

Context: Nonadherence to a prescribed hypertension therapy is a serious nationwide problem. It confounds healthcare professionals ability to control patient's hypertension and leads to uncontrolled or poorly controlled hypertension. This, in tum, is a major risk factor for potentially fatal events such as, CVD, MI, renal failure, and CV A. Studies have shown that both poorly and uncontrolled hypertension is more prevalent among the Native American population than in the general population in the United States. Objective: This study will examine the prevalence and reasons for nonadherence to hypertension therapy among Quileute tribal members. Design: A prospective, descriptive study using an anonymous, voluntary survey asking specific demographic questions as well as questions regarding adherence. Setting: Quileute Health Center located in La Push, W A. Subjects: Quileute tribal members with an established diagnosis of hypertension who are over the age of 18 and not pregnant. Results: A total of 36 surveys were collected and analyzed. Most of the surveys collected were from Quileute tribal members (75%). Of the surveyed population, 37.5% had hypertension and 25% had diabetes. Using this study's definition of medication adherence, 81.25% of the tbtal survey population was "adherent". Variables such as age, gender, education level, frequency of visits to clinic, number of medical conditions, number of medications, and communication were compared with adherence to determine correlation, There were not any statistical significant correlations due to the small number of surveys collected. The most common reason that people were not adherent with medications was forgetfulness. 44% of participants reported that they "always" communicate well with their health care provider. Conclusions: Quileute tribal members were found by self-report to be more adherent than national averages but there were some inconsistencies discovered in survey answers. These may be due to complex cultural differences between Native Americans and people who practice Western allopathic medicine. Because of the inconsistencies, no conclusions could be drawn about medical nonadherence to prescribed HTN therapy. Adherence to healthy lifestyle changes by self-report were very low and need to be addressed. Better communication and acceptance of Native American culture may be instrumental in understanding and negotiating nonadherence in this patient population.


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