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Dr. Edward Adinkrah
Charles R. Drew University of Medicine and Science

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0 chronic disease
0 Underserved
0 medication complexity
0 healthcare utilization
0 minority

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Journal article
Published: 08 September 2020 in International Journal of Environmental Research and Public Health
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Background: For African American middle-aged and older adults with hypertension, poor adherence to medication and lifestyle recommendations is a source of disparity in hypertension outcomes including higher rates of stroke in this population relative to whites. Aims: To study demographic, social, behavioral, cognitive, and medical predictors of adherence to medication and lifestyle recommendations among underserved African American middle-aged and older adults with hypertension. Methods: This was a community-based cross-sectional survey in South Los Angeles with 338 African American middle-aged and older adults with hypertension who were 55 years or older. Age, gender, continuity of care, comorbidity, financial difficulty, self-rated health, depression, educational attainment, adherence knowledge, and adherence worries were the independent variables. Data was analyzed using linear regression with two outcomes, namely, adherence to medication (measured by the first 9 items of the Blood Pressure Self-Care Scale) and adherence to lifestyle recommendations (measured by the second 9 items of the Blood Pressure Self-Care Scale). Results: There were about twice more females than males, with a total mean age of 70 years (range 55–90 years). Various demographic, social, behavioral, and medical factors predicted adherence to medication but not adherence to lifestyle recommendations. Females with hypertension with higher continuity of care, less financial strain, higher knowledge, less negative general beliefs, and concerns about antihypertensive medications had higher adherence to antihypertensive medications. The presence of depressive symptoms, reduced knowledge, and disease management worries were associated with a reduced adherence to lifestyle recommendations. Conclusions: There seem to be fewer demographic, social, behavioral, cognitive, and medical factors that explain adherence to lifestyle recommendations than adherence to medication in economically disadvantaged underserved African American middle-aged and older adults with hypertension. More research is needed on factors that impact adherence to lifestyle recommendations of African American middle-aged and older adults with hypertension.

ACS Style

Edward Adinkrah; Mohsen Bazargan; Cheryl Wisseh; Shervin Assari. Adherence to Hypertension Medications and Lifestyle Recommendations among Underserved African American Middle-Aged and Older Adults. International Journal of Environmental Research and Public Health 2020, 17, 6538 .

AMA Style

Edward Adinkrah, Mohsen Bazargan, Cheryl Wisseh, Shervin Assari. Adherence to Hypertension Medications and Lifestyle Recommendations among Underserved African American Middle-Aged and Older Adults. International Journal of Environmental Research and Public Health. 2020; 17 (18):6538.

Chicago/Turabian Style

Edward Adinkrah; Mohsen Bazargan; Cheryl Wisseh; Shervin Assari. 2020. "Adherence to Hypertension Medications and Lifestyle Recommendations among Underserved African American Middle-Aged and Older Adults." International Journal of Environmental Research and Public Health 17, no. 18: 6538.

Journal article
Published: 16 May 2020 in Pharmacy
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Background. Several publications highlight data concerning multiple chronic conditions and the medication regimen complexity (MRC) used in managing these conditions as well as MRCs’ association with polypharmacy and medication non-adherence. However, there is a paucity of literature that specifically details the correlates of MRC with multimorbidity, socioeconomic, physical and mental health factors in disadvantaged (medically underserved, low income) African American (AA) seniors. Aims. In a local sample in South Los Angeles, we investigated correlates of MRC in African American older adults with chronic disease(s). Methods. This was a community-based survey in South Los Angeles with 709 African American senior participants (55 years and older). Age, gender, continuity of care, educational attainment, multimorbidity, financial constraints, marital status, and MRC (outcome) were measured. Data were analyzed using linear regression. Results. Higher MRC correlated with female gender, a higher number of healthcare providers, hospitalization events and multimorbidity. However, there were no associations between MRC and age, level of education, financial constraint, living arrangements or health maintenance organization (HMO) membership. Conclusions. Disadvantaged African Americans, particularly female older adults with multimorbidity, who also have multiple healthcare providers and medications, use the most complex medication regimens. It is imperative that MRC is reduced particularly in African American older adults with multimorbidity.

ACS Style

Edward Adinkrah; Mohsen Bazargan; Cheryl Wisseh; Shervin Assari. Medication Complexity among Disadvantaged African American Seniors in Los Angeles. Pharmacy 2020, 8, 86 .

AMA Style

Edward Adinkrah, Mohsen Bazargan, Cheryl Wisseh, Shervin Assari. Medication Complexity among Disadvantaged African American Seniors in Los Angeles. Pharmacy. 2020; 8 (2):86.

Chicago/Turabian Style

Edward Adinkrah; Mohsen Bazargan; Cheryl Wisseh; Shervin Assari. 2020. "Medication Complexity among Disadvantaged African American Seniors in Los Angeles." Pharmacy 8, no. 2: 86.

Journal article
Published: 12 April 2020 in Healthcare
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Background: Pervasive racial and economic inequalities have a disproportionate impact on health care utilization among African Americans. One area where we see such disparities is in the recency of eye examinations among the economically disadvantaged. However, our current understanding of the barriers and facilitators of eye examinations in underserved African-American older adults is limited. Aims: Building on Andersen’s model of health service use and using an exploratory approach; we tested various demographic, social, and health factors that were associated with eye examination among underserved middle-aged and older adults in South Los Angeles. We examined predisposing characteristics, enabling factors, and need-for-care characteristics. Methods: With a cross-sectional design, we conducted this survey on a convenience sample of (n = 740) non-institutionalized African-American older adults who were 55+ years old and residing in South Los Angeles, CA, USA. Data were collected on demographic factors, continuity of care, access to care, self-rated health, chronic medical conditions, and depressive symptoms. The outcome was recency of eye examination. Multivariate regression was used for data analysis. Results: 59% of the participants had received at least one eye examination during the last 12 months. A total of 17% had an eye examination within the last two years. Notably, 26% of diabetic participants did not have an eye examination within the last two years. One out of four participants indicated that, within the last two years, no provider ever recommended that they receive an eye examination. Age, education, continuity of medical care, accessibility of medical care, satisfaction with medical care, providers’ recommendation for eye examination, self-rated health, and a diagnosis of hypertension and diabetes mellitus were predictors of eye examination recency. Overall, our analysis indicates that these enabling factors accounted for most of the variance in the recency of eye examinations. Conclusion: A large proportion of underserved African-American middle-aged and older adults in South Los Angeles do not comply with the recommended annual eye examination. This is, in part, because about one-third of them have not received an eye exam recommendation from their health care providers. However, a wide range of factors such as age, education, continuity of care, satisfaction with access, self-rated health, and a diagnosis of hypertension and diabetes mellitus, also influence whether or not African-American middle-aged and older adults receive an eye examination. Programs should address a wide range of multi-level factors to tackle this health inequality.

ACS Style

Mohsen Bazargan; Tavonia Ekwegh; Sharon Cobb; Edward Adinkrah; Shervin Assari. Eye Examination Recency among African American Older Adults with Chronic Medical Conditions. Healthcare 2020, 8, 94 .

AMA Style

Mohsen Bazargan, Tavonia Ekwegh, Sharon Cobb, Edward Adinkrah, Shervin Assari. Eye Examination Recency among African American Older Adults with Chronic Medical Conditions. Healthcare. 2020; 8 (2):94.

Chicago/Turabian Style

Mohsen Bazargan; Tavonia Ekwegh; Sharon Cobb; Edward Adinkrah; Shervin Assari. 2020. "Eye Examination Recency among African American Older Adults with Chronic Medical Conditions." Healthcare 8, no. 2: 94.