(1039) Knowledge of Diabetes and Hypertension Treatment Goals and Medication Adherence among Patients at Federally Qualified Health Centers in Rural Georgia

Objectives: The objectives of this study were to: (1) assess patients’ knowledge of their DM and HTN
treatment/therapeutic goals and medication adherence, and (2) examine associations between
knowledge of treatment goals and medication adherence.

Methods: This study used a cross-sectional study design. An electronic survey was administered to patients
≥ 18 years of age, recruited via convenience sampling at five federally qualified health center
(FQHC) clinics in Southwest Georgia in 2023. Knowledge of therapeutic goals was evaluated
through patients' ability to accurately identify appropriate treatment targets for both DM and
HTN, which included A1c ≤7%, fasting blood sugars 80-130 mg/dl, and BP < 130/80 mm Hg.
The Medication Adherence Rating Scale (MARS) was used to assess patients’ adherence to their
medications. Total scores range from 0 (low medication adherence) to 10 (high adherence).
Descriptive statistics were calculated to characterize study variables. Bivariate and multivariable
regression analyses were used to examine the relationships between sociodemographic
characteristics, knowledge of treatment goals, and medication adherence.

Results: Survey responses were obtained from 127 participants with a mean age of 58 (SD = 16.01) years.
The majority of respondents were female (63%), African American (78%), had a high school
education or less (61%), and had an annual income below $25,000 (44%). Among the
participants, 44%, 52%, and 76% reported awareness of their treatment goals for fasting blood
sugar, postprandial sugar, and HbA1c, respectively. Only 30% of the participants reported
knowledge of their HTN treatment goals. The participants' exhibited low adherence to
medications with a mean adherence score of 2.3 (SD=1.7) for DM medication and 2.5 (SD=1.5)
for HTN medication. Participants who reported an annual income of $50,000 or more, had
attained at least some level of college education, identified as male, and were married had higher
adherence to their DM and HTN medication (p < 0.05). Multivariate analysis showed that a lower
education level was significantly associated with reduced adherence to both DM and HTN
medication (p < 0.05). However, knowledge of treatment goals did not show a significant
association with adherence to either DM or HTN medication.

Conclusions: Study results suggest that rural FQHC patients have low adherence to DM and HTN medications
and that some may lack a clear understanding of their A1c and HTN treatment targets. Tailored
strategies are needed to enhance therapeutic goal knowledge and increase medication adherence
within rural FQHC patient populations. Future studies need to examine the influence of
knowledge on the attainment of treatment goals and health outcomes such as uncontrolled BP,
and diabetes-related complications (e.g., neuropathy, nephropathy).