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Medication Adherence in Older Clinic Patients With Hypertension After Hurricane Katrina: Implications for Clinical Practice and Disaster Management

Background:In post-disaster situations, additional barriers may reduce antihypertensive medication adherence. Methods:Between November 2005 and August 2006, 210 hypertensive patients receiving care at a multispecialty group practice in New Orleans completed a structured questionnaire. Antihypertensive medication adherence was measured with the Hill-Bone medication compliance subscale. In a subset of patients, data on difficulties patients encountered with blood pressure medications in the aftermath of Hurricane Katrina were collected. Results:Seventy-six percent of patients reported damage to their residence and 46% of patients had less-than-perfect medication adherence. After multivariate adjustment, less than perfect medication adherence postdisaster was more common among people aged <65 years (prevalence ratio = 1.37; 95% confidence interval: 1.03–1.82) and non-whites (1.32; 95% confidence interval: 1.02–1.71). Uncontrolled blood pressure (systolic/diastolic ≥140/≥90 mm Hg) was more common in those with less-than-perfect adherence than their counterparts with perfect adherence (51% versus 42%, respectively). In addition, 7% of patients reported not bringing their blood pressure medications when they evacuated, 28% ran out of blood pressure medications, 16% reported difficulties getting medications filled, and 28% reported a blood pressure medication change postdisaster. Conclusions:Opportunities exist to improve disaster planning and prescription refill processes and increase medication adherence and hypertension control postdisasters.