Health Systems and Self-Reported Medication Adherence in Patients with Hypertension: A cross-sectional comparison of Jamaica and Colombia

Health Systems and Self-Reported Medication Adherence in Patients with Hypertension: A cross-sectional comparison of Jamaica and Colombia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Health Systems and Self-Reported Medication Adherence in Patients with Hypertension: A cross-sectional comparison of Jamaica and Colombia Marshall Tulloch-Reid, Selena Lewis, Carene Lindsay, Siyi Geng, and 11 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7454001/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Robust health care systems can support medication adherence as a strategy to improve blood pressure control in Latin America and the Caribbean. The Caribbean and South American Team Based Strategies to Control Hypertension (CATCH) study, conducted in Jamaica and Colombia, allowed us to examine how differing health systems (Jamaica – manual, paper-based, government run vs Colombia - electronic systems utilizing government contracted providers) influenced self-reported antihypertensive medication adherence among hypertensive patients. A total of 576 hypertensive patients from 14 primary care clinics completed telephone interviews between August 2021 and February 2022 during the COVID-19 pandemic. Self-reported medication adherence was measured using the IMPACTS-MAS questionnaire and patients categorized as having high (6), medium (5-5.5) or low (<5) adherence based on score. Country was used as a proxy for health systems in multivariable logistic regression models with medium/low adherence as the primary outcome. Jamaican patients were more likely to report medium/low adherence (49.3% vs 11.8% p <0.001). In Colombia, younger (< 60 years) and never married patients reported more medium/low adherence. Jamaican patients experienced longer wait times for services but were more likely to discuss medication changes with the pharmacist while Colombian patients had more discussions with their doctor. Jamaicans had a higher odds of medium/low adherence compared to Colombians (OR: 6.78 (95% CI: 3.91, 11.75) after adjusting for sociodemographic factors and health care experiences. Further exploration of health system issues that may explain these differences can inform strategies to improve medication adherence in the region. Health sciences/Health care/Prognosis Health sciences/Diseases/Cardiovascular diseases/Hypertension Health sciences/Risk factors Full Text Additional Declarations There is NO conflict of interest to disclose. Table 1 and 2 are available in the Supplementary Files section. Supplementary Files Table1JournalofHumanHypertensionFinal.pdf Table 1 Table2JournalofHumanHypertensionFinal.pdf Table 2 Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7454001","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":507279001,"identity":"b73e7f6c-499f-418a-ac26-eec59cc9f933","order_by":0,"name":"Marshall 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The Caribbean and South American Team Based Strategies to Control Hypertension (CATCH) study, conducted in Jamaica and Colombia, allowed us to examine how differing health systems (Jamaica – manual, paper-based, government run vs Colombia - electronic systems utilizing government contracted providers) influenced self-reported antihypertensive medication adherence among hypertensive patients. A total of 576 hypertensive patients from 14 primary care clinics completed telephone interviews between August 2021 and February 2022 during the COVID-19 pandemic. Self-reported medication adherence was measured using the IMPACTS-MAS questionnaire and patients categorized as having high (6), medium (5-5.5) or low (\u003c5) adherence based on score. Country was used as a proxy for health systems in multivariable logistic regression models with medium/low adherence as the primary outcome. Jamaican patients were more likely to report medium/low adherence (49.3% vs 11.8% p \u003c0.001). 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