Decoding Nonadherence to Hypertensive Medication in New York City: A Population Segmentation Approach. (February 2019)

• Record Type: Journal Article
• Authors: Li, Yan; Jasani, Foram; Su, Dejun; Zhang, Donglan; Shi, Lizheng; Yi, Stella S.; Pagán, José A.
• Is Part Of: Journal of primary care & community health. Volume 10(2019)
• Publication Date: 2019-02
• Subjects: community health -- disease management -- health promotion -- managed care -- medications -- primary care -- prevention; Primary health care -- Periodicals; Primary health care -- United States -- Periodicals; Community health services -- Periodicals; Community health services -- United States -- Periodicals; 362.12
• DOI: 10.1177/2150132719829311
• Languages: English
• ISSNs: 2150-1319

Abstract

Objective: Nearly one-third of adults in New York City (NYC) have high blood pressure and many social, economic, and behavioral factors may influence nonadherence to antihypertensive medication. The objective of this study is to identify profiles of adults who are not taking antihypertensive medications despite being advised to do so.Methods: We used a machine learning–based population segmentation approach to identify population profiles related to nonadherence to antihypertensive medication. We used data from the 2016 NYC Community Health Survey to identify and segment adults into subgroups according to their level of nonadherence to antihypertensive medications.Results: We found that more than 10% of adults in NYC were not taking antihypertensive medications despite being advised to do so by their health care providers. We identified age, neighborhood poverty, diabetes, household income, health insurance coverage, and race/ethnicity as important characteristics that can be used to predict nonadherence behaviors as well as used to segment adults with hypertension into 10 subgroups.Conclusions: Identifying segments of adults who do not adhere to hypertensive medications has practical implications as this knowledge can be used to develop targeted interventions to address this population health management challenge and reduce health disparities.