The effect of doctor-patient communication on blood pressure control in hypertensive patients: Mediating role of medication adherence

IF 2.6 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung Pub Date : 2025-05-29 DOI:10.1016/j.hrtlng.2025.05.005

Tao Liu MD , Xinchun Liu PhD , Jianwei Zeng MM , Xiexiong Zhao MD , Liping Peng MD , Huizhen Zhou MM , Xiaogang Li MD, PhD , Weihong Jiang MD, PhD

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引用次数: 0

Abstract

Background

Both doctor‒patient communication and medication adherence are related to blood pressure control in hypertensive patients. The connections among doctor‒patient communication, medication adherence, and blood pressure control have not been fully explained.

Objective

This study aimed to investigate the effect of doctor-patient communication on blood pressure control and to test the hypothesis of medication adherence as a mediator.

Methods

In Changsha, China, this cross-sectional study was carried out in 10 affiliated communities of community health centers from January to October 2023. A multistage stratified sampling method gathered a diverse population. A structured questionnaire utilized the Set-Elicitation-Give-Understand-End (SEGUE) framework to evaluate doctor-patient communication and the Morisky Medication Adherence Scale-8 (MMAS-8) scale to assess medication adherence. Binary logistic regression was used to analyze the effect of doctor‒patient communication on blood pressure control. Stepwise regression was used to test the mediating effect of medication adherence on this effect.

Results

A total of 431 valid questionnaires were analyzed. A total of 66.8 % of the participants experienced poor doctor‒patient communication, and 142 participants (32.9 %) demonstrated good blood pressure control. Both univariate and multivariable logistic analyses revealed that patients with better doctor–patient communication had better blood pressure control (OR=6.93, P < 0.001; OR=6.52, P < 0.001). A total of 214 participants (49.7 %) exhibited good medication adherence. Medication adherence had a mediating effect of 0.13 (26.5 % of the total effect, P < 0.001).

Conclusion

Doctor-patient communication had a significant positive effect on blood pressure control in patients with hypertension and medication adherence was a partial mediator.

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医患沟通对高血压患者血压控制的影响：服药依从性的中介作用

背景高血压患者的医患沟通和药物依从性与血压控制有关。医患沟通、药物依从性和血压控制之间的联系尚未得到充分解释。目的探讨医患沟通对血压控制的影响，并验证药物依从性在血压控制中的中介作用。方法于2023年1 - 10月在中国长沙市10个社区卫生中心附属社区开展横断面研究。采用多阶段分层抽样方法收集了不同的人口。采用结构化问卷，采用set - elicicita - give - understand - end （SEGUE）框架评估医患沟通，采用Morisky药物依从性量表-8 （MMAS-8）评估药物依从性。采用二元logistic回归分析医患沟通对血压控制的影响。采用逐步回归检验药物依从性对该效应的中介作用。结果共回收有效问卷431份。共有66.8%的参与者经历了医患沟通不良，142名参与者（32.9%）表现出良好的血压控制。单因素和多因素logistic分析均显示，医患沟通较好的患者血压控制较好(OR=6.93, P <；0.001;OR=6.52, P <；0.001)。共有214名参与者（49.7%）表现出良好的药物依从性。药物依从性的中介效应为0.13(占总效应的26.5%,P <；0.001)。结论医患沟通对高血压患者血压控制有显著的正向作用，药物依从性是部分中介因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart & Lung 医学-呼吸系统

CiteScore

4.60

自引率

3.60%

发文量

184

审稿时长

35 days

期刊介绍： Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders. The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.