Table 1.
Meta-analysis of medication utilization and adherence outcomes
| Analysis | N cohorts* | Rural/urban OR of treatment (95% CI) | I 2 (%) | Subgroup difference |
|---|---|---|---|---|
|
Cardiovascular medication utilization | ||||
| Overall - unadjusted |
26 |
0.88 (0.79, 0.98) |
97 |
NA |
| Overall - adjusted |
23 |
1.02 (0.91, 1.13) |
97 |
NA |
|
Subgroup analysis – adjusted |
|
|
|
|
|
Setting |
|
|
|
|
| Community or population-based |
8 |
1.15 (1.06, 1.25) |
71 |
P < 0.0001 |
| Hospital |
6 |
0.87 (0.83, 0.92) |
34 |
|
| Ambulatory care practice |
9 |
1.02 (0.85, 1.24) |
78 |
|
|
Drug class |
|
|
|
|
| Antithrombotic or anticoagulant |
9 |
1.00 (0.88, 1.14) |
88 |
P = 0.62 |
| Antihypertensive |
16 |
1.03 (0.90, 1.17) |
92 |
|
| Lipid lowering agent |
4 |
0.94 (0.83, 1.07) |
37 |
|
|
Disease |
|
|
|
|
| Atrial fibrillation |
3 |
0.83 (0.59, 1.16) |
67 |
P = 0.0001 |
| Cardiovascular disease |
11 |
0.95 (0.88, 1.03) |
67 |
|
| Hypertension |
6 |
1.07 (0.87, 1.33) |
79 |
|
| Diabetes |
3 |
1.21 (1.12, 1.31) |
76 |
|
|
Age (study mean or median) |
|
|
|
|
| <65 years |
8 |
1.15 (1.04, 1.26) |
80 |
P = 0.005 |
| ≥65 years |
12 |
0.98 (0.88, 1.08) |
70 |
|
| Not reported |
3 |
0.89 (0.77, 1.02) |
64 |
|
|
Country |
|
|
|
|
| US |
18 |
1.01 (0.92, 1.10) |
87 |
P = 0.67 |
| Non-US |
5 |
1.05 (0.88, 1.26) |
88 |
|
|
Publication Year |
|
|
|
|
| 1999-2005 |
7 |
1.06 (0.91, 1.22) |
76 |
P = 0.66 |
| 2006-2011 |
16 |
1.01 (0.88, 1.15) |
98 |
|
|
Data source |
|
|
|
|
| Administrative data |
2 |
1.17 (0.97, 1.41) |
87 |
P = 0.19 |
| Medical record |
14 |
0.97 (0.87, 1.08) |
86 |
|
| Patient self-report |
7 |
1.07 (0.93, 1.22) |
72 |
|
|
Cardiovascular medication adherence | ||||
| |
N |
Rural/urban OR of treatment (95% CI) |
I
2
(%) |
Subgroup difference |
| Overall - unadjusted | 4 | 0.94 (0.39, 2.27) | 91 | NA |