The Impact of Patient-Physician Racial Concordance on Medication Adherence in the Hypertensive Patient Population

Racial disparities contribute to lower quality of care and increased morbidity and mortality for racial and ethnic minorities, as compared to nonminority groups (Egede, 2006). Notably, these inequalities are pronounced in the hypertensive population. For example, Blacks have more severe, uncontrolled hypertension, higher disease risks, and earlier age of hypertension onset than Whites (Lackland, 2014). Another driver of these disparities is racial discordance among patients and their physicians, with those in racially congruent patient-physician alliances more readily receiving the appropriate medical care and intending to adhere (Saha, Komaromy, Koepsell & Bindman, 1999; Street, O’Malley, Cooper & Haidet, 2008). Adherence with treatment is especially important for hypertensive individuals, for nonadherence to antihypertensive medications is the leading cause of uncontrolled blood pressure and may increase cardiovascular risk (Burnier & Wuerzner, 2015). Therefore, understanding the factors influencing a patient’s tendency to adhere to medicinal regimens may reverse trends of this chronic condition. Given the racial discrepancies in those with hypertension and knowing that physician-patient racial discordance exacerbates health care inequalities, the following review sought to summarize the literature on the impact of physician-patient racial concordance on the rates of medication adherence in hypertensive adults. This review included three manuscripts, all of which did not find associations between race concordance and medication adherence in patients with high blood pressure. Instead, patient trust, collaborative communication, and continuity of care significantly impacted this outcome. Thus, future research should explore patient adherence on the basis of these three predictors