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. 2013 Nov-Dec;9(6):817-27.
doi: 10.1016/j.sapharm.2012.12.002. Epub 2013 Jan 4.

Prevalence and correlates of self-reported medication non-adherence among older adults with coronary heart disease, diabetes mellitus, and/or hypertension

Zachary A Marcum  1 , Yan Zheng, Subashan Perera, Elsa Strotmeyer, Anne B Newman, Eleanor M Simonsick, Ronald I Shorr, Douglas C Bauer, Julie M Donohue, Joseph T Hanlon; Health ABC Study
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Prevalence and correlates of self-reported medication non-adherence among older adults with coronary heart disease, diabetes mellitus, and/or hypertension

Zachary A Marcum et al. Res Social Adm Pharm. 2013 Nov-Dec.

Abstract

Background: Information about the prevalence and correlates of self-reported medication nonadherence using multiple measures in older adults with chronic cardiovascular conditions is needed.

Objective: To examine the prevalence and correlates of self-reported medication nonadherence among community-dwelling elders with chronic cardiovascular conditions.

Methods: Participants (n = 897) included members from the Health, Aging and Body Composition Study with coronary heart disease, diabetes mellitus, and/or hypertension at Year 10. Self-reported nonadherence was measured by the 4-item Morisky Medication Adherence Scale (MMAS-4) and 2-item cost-related nonadherence (CRN-2) scale at Year 11. Factors (demographic, health status, and access to care) were examined for association with the MMAS-4 and then for association with the CRN-2 scale.

Results: Nonadherence per the MMAS-4 and CRN-2 scale was reported by 40.7% and 7.7% of participants, respectively, with little overlap (3.7%). Multivariable logistic regression analyses found that black race was significantly associated with nonadherence per the MMAS-4 (P = 0.002) and the CRN-2 scale (P = 0.005). Other correlates of nonadherence per the MMAS-4 (with independent associations) included having cancer (P = 0.04), a history of falls (P = 0.02), sleep disturbances (P = 0.04) and having a hospitalization in the previous 6 months (P = 0.005). Conversely, being unmarried (P = 0.049), having worse self-reported health (P = 0.04) and needs being poorly met by income (P = 0.02) showed significant independent associations with nonadherence per the CRN-2 scale.

Conclusions: Self-reported medication nonadherence was common in older adults with chronic cardiovascular conditions and only one factor - race - was associated with both types. The research implication of this finding is that it highlights the need to measure both types of self-reported nonadherence in older adults. Moreover, the administration of these quick measures in the clinical setting should help identify specific actions such as patient education or greater use of generic medications or pill boxes that may address barriers to medication nonadherence.

Keywords: Aged; Chronic disease; Medication adherence.

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References

    1. Federal Interagency Forum on Aging-Related Statistics . Older Americans 2010: Key Indicators of Well-Being. Federal Interagency Forum on Aging-Related Statistics. U.S. Government Printing Office; Washington, DC: Jul, 2010.
    1. Munger MA, Van Tassell BW, LaFleur J. Medication nonadherence: an unrecognized cardiovascular risk factor. MedGenMed. 2007;9:58. - PMC - PubMed
    1. Resnick HE, Shorr RI, Kuller L, Franse L, Harris TB. Prevalence and clinical implications of American Diabetes Association-defined diabetes and other categories of glucose dysregulation in older adults: the health, aging and body composition study. J Clin Epidemiol. 2001;54:869–76. - PubMed
    1. Smith NL, Savage PJ, Heckbert SR, et al. Glucose, blood pressure, and lipid control in older people with and without diabetes mellitus: the Cardiovascular Health Study. J Am Geriatr Soc. 2002;50:416–23. - PubMed
    1. de Rekeneire N, Rooks RN, Simonsick EM, et al. Health, Aging and Body Composition Study. Racial differences in glycemic control in a well-functioning older diabetic population: findings from the Health, Aging and Body Composition Study. Diabetes Care. 2003;26:1986–92. - PubMed

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