Initial acceptance of treatment with antihypertensive medication: The importance of communication, trust and beliefs.

Uncontrolled hypertension is a significant health problem, due in part to patients' under-use of antihypertensive medications. This study explored what factors influence patients' decisions to accept or resist initiation of pharmacologic therapy for hypertension. A total of 210 subjects reviewed a clinical vignette and a hypothetical physician-patient dialogue. They then self-reported their likelihood of accepting the physician's recommendation to initiate therapy with an antihypertensive. Additional measures included trust in the physician, satisfaction, beliefs about medication effectiveness, safety and side-effects, and beliefs about hypertension. Analyses included bivariate correlations and multivariate linear regression. Findings suggest that the strongest correlates of intent to begin therapy were trust in the physician (r = 0.65, p< 0.01), satisfaction with communication (r= 0.53, p< 0.01), and belief that medications can effectively treat hypertension (r = 0.45, p< 0.01). Three other beliefs were also correlated with acceptance of treatment: the belief that physicians do not prescribe unsafe medications (r=0.25, p<0.01), worry about having hypertension (r = 0.18, p<0.01) and belief that hypertension is a very serious disease (r= 0.26, p<0.01). Acceptance of treatment was not correlated with worry about medication side-effects or belief that medications cause problems (p> 0.01). The tone of the dialogue (positive versus negative) did not result in statistically significant differences in subjects' responses on any measures. The study concludes that attention to patients' perceptions and beliefs about hypertension and medication efficacy may help patients accept pharmacologic treatment. [ABSTRACT FROM AUTHOR]