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Kidney Week

Abstract: FR-PO826

African American ESRD and Medication Adherence: What Are the Effects of Everyday Racism?

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Author

  • Savage, Tamara, UNC Pembroke, Pembroke, North Carolina, United States
Background

Poor medication adherence leads to increased hospitalizations, morbidity, and mortality in end-stage renal disease (ESRD) patients. African American ESRD patients have poorer rates of medication adherence when compared to Whites. Studies have not investigated the impact of broader social issues such as everyday racism on this racial disparity. This is the first study to explore how everyday racism within the healthcare system contributes to this disparity in medication adherence. A mixed methods study was conducted to investigate the relationship between everyday racism and medication adherence within the African American ESRD community.

Methods

Primary data were collected from 46 African American ESRD patients. All participants completed a questionnaire comprised of demographic information, a medication adherence survey, and an everyday racism in the healthcare setting survey. Additionally, 27 of the total sample (N=46) participated in in-depth interviews which lasting approximately one hour. Participants were recruited from attendees at two patient-centered meetings in Greensboro, NC and Nashville, TN. Pearson’s Correlation was used to analyze quantitative data and Constructivist Grounded Theory was used to identify themes that emerged from interview transcripts.

Results

A statistically significant negative relationship was found between medication adherence and everyday racism in the healthcare system (r = -.477, p < .01). As everyday racism increased, medication adherence decreased. Furthermore, interviews revealed that everyday racism perpetuated within the healthcare system negatively affected participants’ medication adherence. Three themes were identified: 1) Concern that medical providers were not knowledgeable about the medications they were prescribing 2) Concern that the medication was not safe 3) Information about medication and lab results withheld or given to participants without further consultation.

Conclusion

These findings provide the basis for development of future research that could lead to interventions with healthcare systems and professionals to address the medication adherence disparity.

Funding

  • Private Foundation Support