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. 2019 Jul 11:13:1111-1123.
doi: 10.2147/PPA.S201707. eCollection 2019.

Decomposing the effect of drug benefit program on antihypertensive medication adherence among the elderly in urban China

Xiaochen Ma #  1 , Yuji Zhang #  2 , Mei Zhang  2 , Xiaoju Li  2 , Hongpo Yin  2 , Ke Li  3 , Mingxia Jing  2
Affiliations

Decomposing the effect of drug benefit program on antihypertensive medication adherence among the elderly in urban China

Xiaochen Ma et al. Patient Prefer Adherence. .

Abstract

Purpose: Hypertension is a rapidly growing epidemic in People's Republic of China, yet it remains inadequately controlled. This study aimed to identify the relative contributions of program effects and patients' characteristics to the differences in antihypertensive medication nonadherence between drug benefit program enrollees and non-enrollees.

Patients and methods: Data were from a cross-sectional survey of 1,969 community-dwelling elderly adults with hypertension. Self-reported adherence was measured following previous studies in People's Republic of China. The Blinder-Oaxaca nonlinear decomposition method was used to identify the relative contributions of program effects and patients' individual characteristics.

Results: Eleven percent of the drug benefit program enrollees were nonadherent to their medication, while 17% of non-enrollees were. Blinder-Oaxaca decomposition identified that over 60% of the gap between the two groups was due to the program effects (P=0.024). The rest could be explained by differences in observable characteristics (P<0.001), such as diabetic status, duration of hypertension, and blood pressure control.

Conclusion: The study confirmed that drug benefit program enrollees were more likely to be adherent to their antihypertensive medication than non-enrollees in the context of People's Republic of China.

Keywords: decomposition; drug benefit program; hypertension; medication adherence.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
OR for medication nonadherence by drug benefit program enrollment status. Notes: The x-axis refers to magnitude of the OR. Black horizontal lines reflect 95% CIs.
Figure 2
Figure 2
Contribution of drug benefit program effects to antihypertensive medication nonadherence. Notes: Other observed characteristics adjusted for in the decomposition analysis were gender, age, education, annual household income, urbanity, other frequency of clinic check-ups, and other duration of hypertension.
Figure 3
Figure 3
Contribution of observable characteristics to antihypertensive medication nonadherence. Notes: Other observed characteristics adjusted for in the decomposition analysis were gender, age, education, annual household income, urbanity, other frequency of clinic check-ups, and other duration of hypertension.
See this image and copyright information in PMC

References

    1. Olsen MH, Angell SY, Asma S, et al. A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations: the Lancet commission on hypertension. Lancet. 2016;388:2665–2712. doi:10.1016/S0140-6736(16)31134-5 - DOI - PubMed
    1. Lu J, Lu Y, Wang X, et al. Prevalence, awareness, treatment, and control of hypertension in China: data from 1.7 million adults in a population-based screening study (China PEACE Million Persons Project). Lancet. 2017;390(10112):2549–2558. doi:10.1016/S0140-6736(17)32478-9 - DOI - PubMed
    1. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353(18):487–497. doi:10.1056/NEJMra050100 - DOI - PubMed
    1. Mojtabai R, Olfson M. Medication costs, adherence, and health outcomes among Medicare beneficiaries. Health Aff (Millwood). 2003;22(4):220–229. doi:10.1377/hlthaff.22.4.220 - DOI - PubMed
    1. Wang Y. Investigation and Prevention on Chronic Disease in China. Beijing: China Social Sciences Press; 2011:39–40.