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As a clinical nurse educator on the cardiac surgical unit at Abington Jefferson Health, Tierra Smith 鈥�21 MSN, CCRN-CSC, spent three years teaching nurses how to care for patients with cardiac disease and an array of other cardiac issues. 鈥淗owever, I鈥檓 learning that to really effect change, educators must start with prevention,鈥� says Tierra, who is now a nurse professional development specialist at the hospital.

And so she spent the final year of her master鈥檚 program in Nursing Education at 棉花糖直播鈥檚 M. Louise Fitzpatrick College of Nursing immersed in preventive research with the potential to make a major impact. Specifically, what are the barriers that contribute to non-adherence to medication for African American women with high blood pressure?

With guidance from 棉花糖直播 Nursing Professor Mary Ann Cantrell, PhD, RN, CNE, FAAN, Tierra embarked on a literature review to uncover some answers in the research鈥攁nd seek to bring about a change in practice.

The Significance

According to the American Heart Association, African American women in the US have the highest prevalence of high blood pressure, clinically known as hypertension, both nationwide and worldwide鈥攁nd those rates continue to increase. 鈥淎s an African American woman, I have always been interested in health disparities that disproportionately affect minorities,鈥� says Tierra, noting that this population is vastly underrepresented in the literature.

The Findings

鈥淎ffecting medication adherence in this population requires a multi-factorial approach that should consider social and discriminatory factors,鈥� Tierra explains. In addition to key factors that include age, income, knowledge about medication, medication side effects, and the asymptomatic nature of the disease, the cost of medications as well as unsatisfactory patient/provider interactions lead to non-adherence. Racism and discrimination are also factors: 鈥淪ome patients felt they just weren鈥檛 being heard when they voiced concerns,鈥� Tierra says. 鈥淭hey thought physicians possibly didn鈥檛 listen just because of who they were.鈥�

The Takeaway

鈥淪ometimes patients who don鈥檛 comply with their treatment regimen are looked at negatively,鈥� Tierra says. 鈥淲e in the medical community need to look at patients holistically, as whole people, find out what鈥檚 holding them back, and see how we can help them to adhere to their treatment regimen and gain better outcomes.鈥�