Barriers to Medication Adherence and Mild Cognitive Impairment Among African Americans with Persistently Uncontrolled Hypertension: A Cross-sectional Analysis from the Southeastern Collaboration Trial.

BACKGROUND

Mild cognitive impairment (MCI) is frequently undetected and may lead to medication nonadherence. We examined whether more reported barriers to medication adherence could signal the presence of MCI.

OBJECTIVE

We developed a count of barriers (0, 1, 2, and ≥3) and determined the independent association between a greater number of barriers and odds of MCI.

SETTING

Rural primary care practices in Alabama and North Carolina.

PARTICIPANTS

One thousand two hundred seventy-nine participants of the Southeastern Collaboration to Improve Blood Pressure Control trial; all were African Americans with persistently uncontrolled hypertension.

MAIN MEASURE: Presence of mild cognitive impairment (MCI).

RESULTS

Participants reporting ≥ 2 barriers had 2.40 (95% CI 1.03-5.75) times higher adjusted odds of MCI compared to those reporting none; those reporting ≥ 3 barriers had 3.80 (95% CI 1.74-8.31) higher odds. As the number of barriers increased, odds of MCI increased (p for trend < 0.001).

CONCLUSION

Barriers to medication adherence may signal MCI.