Poor Medication Adherence in African Americans Is a Matter of Trust

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Poor Medication Adherence in African Americans Is a Matter of Trust Gregory L. Hall 1

&

Michele Heath 2

Received: 8 February 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 # W. Montague Cobb-NMA Health Institute 2020

Abstract The purpose of this paper was to explore the lack of medication adherence in the African American patient community. The paper will address myths that many African American patients believe related to type 2 diabetes, hypertension treatment, and natural remedies. Research has shown that the disparities in the acceptance of healthcare provider advice and prescriptions are a significant concern particularly in African American patients. The acceptance of a provider’s diagnosis and subsequent intervention can vary based on several issues including healthcare access, patient preferences, trust of a provider, and treatment recommendations. Patient influences can range from their ability to trust the provider (and what he/she says) to following through with their advice. Several studies have looked at the beliefs and misconceptions some African Americans hold regarding the treatment of hypertension and diabetes with some showing a preference for “natural remedies.” This paper will leverage a literature review to seek out myths from African American patients to understand why they are dealing with challenges related to adherence with medication. The searches identified 58 research papers. The study applied an inductive content analysis approach to assess the research papers and identify themes. The barriers identified in this study include disbelief of the diagnosis, distrust for medication, mistrust for physicians and healthcare system, belief in alternative medicine, cultural/generation norms, and access/affordability of care. One of the most prominent factors that crossed all barriers was medical mistrust. Keywords Medication adherence . Health disparities . Hypertension . Diabetes . African American

Introduction Disparities in healthcare with particularly poor outcomes in African Americans in the USA remain a national priority. Research has shown that racial and ethnic minorities have a higher prevalence of chronic conditions along with higher rates of mortality and poorer health outcomes when compared with the white population [1]. African Americans have witnessed improvements in civil rights, housing, education, and income over the years, but the inequities in healthcare outcomes remain stark [2]. African Americans are faced with many healthcare-related challenges, including health insurance coverage, access to medical care, and in some instances, * Michele Heath [email protected] Gregory L. Hall [email protected] 1

Northeast Ohio Medical University College of Medicine, 464 Richmond Road, Suite 201, Richmond Heights, OH 44143, USA

2

Cleveland State University, 1860 E. 18th Street, BU 440, Cleveland, OH 44114, USA

poor quality of care delivery. These disparities are deeply rooted in larger social, economic, and political dysfunctions that disadvantages African Americans [3]