Table 2.
Bivariate logistic regression analyses of medication nonadherence correlates in older adults with Coronary Heart Disease, Diabetes Mellitus, and Hypertension (n=897)
Potential Correlate | Nonadherence Outcome | |||
---|---|---|---|---|
MMAS-4 | CRN-2 | |||
Odds Ratio (95% CI) |
p-Value | Odds Ratio (95% CI) |
p-Value | |
Demographic Factors | ||||
Age | 0.95 (0.91-1.00) | 0.05 | 0.98 (0.90-1.07) | 0.65 |
Sex: Male vs Female | 0.99 (0.76-1.30) | 0.96 | 0.69 (0.42-1.14) | 0.15 |
Race: Black vs White | 1.48 (1.12-1.95) | 0.005 | 2.23 (1.36-3.65) | 0.002 |
Education | ||||
Postsecondary | 1.00 (Reference) | -- | 1.00 (Reference) | -- |
Less than high school | 1.35 (0.94-1.91) | 0.10 | 2.27 (1.24-4.16) | 0.008 |
High school | 1.15 (0.85-1.55) | 0.38 | 1.38 (0.76-2.49) | 0.29 |
Literacy level | ||||
≥ 9th grade | 1.00 (Reference) | -- | 1.00 (Reference) | -- |
≤ 6th grade | 1.13 (0.79-1.62) | 0.50 | 2.35 (1.32-4.21) | 0.004 |
7th–8th grade | 1.15 (0.80-1.66) | 0.44 | 1.62 (0.85-3.10) | 0.14 |
Memphis site | 1.32(1.01-1.72) | 0.04 | 1.63 (0.98-2.70) | 0.06 |
Married | 0.95 (0.73-1.24) | 0.70 | 0.37(0.21-0.65) | 0.001 |
Health Status Factors | ||||
Number of regularly scheduled medications |
||||
0-4 | 1.00 (Reference) | -- | 1.00 (Reference) | -- |
5-8 | 1.26 (0.93-1.69) | 0.13 | 1.08 (0.61-1.91) | 0.17 |
≥9 | 1.16 (0.79-1.69) | 0.45 | 1.78 (0.93-3.37) | 0.18 |
Number of chronic cardiovascular conditions (DM, CHD, HTN) |
||||
1 | 1.00 (Reference) | -- | 1.00 (Reference) | -- |
2 | 1.19 (0.89-1.59) | 0.23 | 1.51 (0.89-2.57) | 0.13 |
3 | 0.62 (0.39-0.99) | 0.04 | 1.63 (0.77-3.45) | 0.20 |
Osteoporosis | 1.27 (0.84-1.93) | 0.26 | 1.21 (0.58-2.52) | 0.61 |
Cancer | 0.82 (0.60-1.13) | 0.22 | 0.71 (0.38-1.32) | 0.27 |
Depression (CES-D > 15) | 1.12 (0.73-1.72) | 0.60 | 1.30 (0.62-2.72) | 0.49 |
Cognitive impairment (3MS < 80) |
0.99 (0.68-1.47) | 0.98 | 0.94 (0.45-1.94) | 0.86 |
CVA | 1.34 (0.89-2.03) | 0.17 | 1.18 (0.57-2.47) | 0.65 |
Dyslipidemia (LDL >130) | 1.19 (0.85-1.66) | 0.31 | 1.17 (0.64-2.16) | 0.61 |
BMI (kg/m2) | ||||
>30 | 1.00 (Reference) | -- | 1.00 (Reference) | -- |
<25 | 0.94 (0.66-1.34) | 0.74 | 0.68 (0.36-1.26) | 0.22 |
25-30 | 1.01 (0.74-1.39) | 0.94 | 0.60 (0.34-1.07) | 0.08 |
Moderate/high intensity exercise | 0.88 (0.65-1.19) | 0.40 | 0.68 (0.37-1.25) | 0.21 |
Fair/poor self-rated health (vs. excellent/very good/good) |
1.40(1.02-1.92) | 0.04 | 2.03 (1.21-3.40) | 0.008 |
Physical function limitation | 1.25 (0.92-1.69) | 0.15 | 1.94 (1.17-3.23) | 0.011 |
Falls | 1.51 (1.14-2.01) | 0.004 | 0.78 (0.45-1.36) | 0.38 |
Sleep disturbances | 1.48 (1.12-1.96) | 0.005 | 1.45 (0.86-2.43) | 0.16 |
Vision problems | 1.03 (0.49-2.18) | 0.94 | 0.42 (0.06-3.13) | 0.40 |
Hearing problems | 0.86 (0.46-1.62) | 0.63 | 0.57 (0.14-2.42) | 0.45 |
Current smoker | 1.06 (0.48-2.33) | 0.89 | 2.24 (0.75-6.71) | 0.15 |
Flu shot in previous year | 0.70 (0.49-0.99) | 0.04 | 0.72 (0.40-1.32) | 0.29 |
Access to Health Care Factors | ||||
Family income < $25,000 | 1.27 (0.96-1.68) | 0.09 | 2.62 (1.54-4.46) | <0.001 |
Needs poorly met by income (vs. very well/fairly well) |
1.39 (0.75-2.57) | 0.29 | 4.36 (2.04-9.33) | <0.001 |
Home ownership | 1.07 (0.63-1.80) | 0.80 | 0.94 (0.36-2.44) | 0.89 |
Other assets | ||||
3-7 | 1.00 (Reference) | -- | 1.00 (Reference) | -- |
0 | 1.25 (0.88-1.78) | 0.21 | 4.09 (2.11-7.95) | <0.0001 |
1-2 | 1.18 (0.85-1.63) | 0.33 | 2.25 (1.14-4.47) | 0.02 |
Health insurance | 1.03 (0.71-1.49) | 0.86 | 1.08 (0.54-2.17) | 0.83 |
Prescription medication insurance | 1.01 (0.57-1.79) | 0.97 | 0.95 (0.33-2.73) | 0.92 |
Private doctor as the usual place to go for health care (vs. Othera) |
0.93 (0.60-1.44) | 0.74 | 2.58 (0.79-8.37) | 0.12 |
Hospitalization in previous 6 months |
1.43 (0.96-2.13) | 0.08 | 1.05 (0.51-2.18) | 0.89 |
Abbreviations: 3MS: modified mini-mental state exam; BMI: body mass index; CES-D: Center for Epidemiologic Studies Depression scale; CHD: coronary heart disease; CRN-2: 2-item cost-related nonadherence; CVA: cerebrovascular accident; DM: diabetes mellitus; HTN: hypertension; LDL: low density lipoprotein; MMAS-4: 4-item Morisky Medication Adherence Scale
“Other” included: public clinic, HMO, hospital outpatient clinic, emergency room, or other