Table 4. Crude and adjusteda,b prevalence ratios of low adherence to treatment for chronic diseases by adults aged 20 or over in Brazil, by analyzed variables. PNAUM, Brazil, 2014. (N = 11,842).
| Variablec | Crude analysis | Adjusted analysis | ||||
|---|---|---|---|---|---|---|
|
|
|
|||||
| PR | 95%IC | pd | PR | 95% IC | Pd | |
| Level 1 | ||||||
| Demographic characteristics | ||||||
| Gender | 0.017 | |||||
| Male | Ref | |||||
| Female | 1.13 | 1.02–1.25 | ||||
| Age (years) | < 0.001 | < 0.001 | ||||
| 20-39 | 1.34 | 1.16–1.56 | 1.64 | 1.39-1.93 | ||
| 40-59 | 1.05 | 0.95–1.16 | 1.16 | 1.04-1.29 | ||
| ≥ 60 | Ref | |||||
| Skin color | 0.383 | |||||
| White | Ref | |||||
| Non-white | 1.04 | 0.94–1.16 | ||||
| Marital status | 0.409 | |||||
| With partner | Ref | |||||
| Without partner | 1.03 | 0.95–1.12 | ||||
| Socioeconomic characteristics | ||||||
| Level of education (years of study) | 0.003 | |||||
| No education | 1.11 | 0.97–1.27 | ||||
| 1 to 8 years | 0.89 | 0.81–0.99 | ||||
| ≥ 8 years | Ref | |||||
| Economic status ABEPd | 0.372 | |||||
| A/B | Ref | |||||
| C | 0.98 | 0.86–1.12 | ||||
| D/E | 1.06 | 0.90–1.25 | ||||
| Brazilian region | < 0.001 | < 0.001 | ||||
| North | Ref | |||||
| Northeast | 1.68 | 1.37–2.05 | 1.33 | 1.10-1.61 | ||
| Southeast | 1.28 | 1.03–1.61 | 1.11 | 0.90-1.38 | ||
| South | 1.18 | 0.96–1.44 | 0.98 | 0.81-1.18 | ||
| Midwest | 1.56 | 1.26–1.94 | 1.21 | 1.00-1.47 | ||
| Health plan | 0.102 | 0.031 | ||||
| Yes | 0.91 | 0.82–1.01 | 0.89 | 0.81-0.99 | ||
| No | Ref | |||||
|
| ||||||
| Level 2 | ||||||
|
| ||||||
| Health system characteristics | ||||||
| Visits doctor to treat chronic diseases | 0,668 | |||||
| Yes | Ref | |||||
| No | 0.96 | 0.82–1.12 | ||||
| Number of doctors visited to treat chronic diseases | < 0.001 | < 0.001 | ||||
| One | Ref | |||||
| More than one | 1.47 | 1.34–1.61 | 1.16 | 1.06-1.26 | ||
| Free access to drug therapy for chronic diseases | < 0.001 | < 0.001 | ||||
| All free | Ref | |||||
| Any free | 1.83 | 1.64–2.04 | 1.32 | 1.18-1.49 | ||
| None free | 1.14 | 1.01–1.28 | 1.14 | 1.02-1.29 | ||
| Number of hospitalizations in the previous 12 months | < 0.001 | |||||
| None | Ref | |||||
| 1 | 1.15 | 0.99–1.34 | ||||
| 2 or more | 1.73 | 1.44–2.08 | ||||
| Number of emergency visits in the previous 12 months | < 0.001 | < 0.001 | ||||
| None | Ref | |||||
| 1 | 1.47 | 1.32–1.63 | 1.14 | 1.03-1.27 | ||
| 2 or more | 1.84 | 1.63–2.09 | 1.32 | 1.18-1.48 | ||
| Self-perceived health and morbidities | ||||||
| Self-perceived health | < 0.001 | |||||
| Very good | Ref | |||||
| Good | 1.45 | 0.99–2.12 | ||||
| Average | 2.08 | 1.40–3.08 | ||||
| Poor | 2.69 | 1.78–4.07 | ||||
| Very poor | 2.88 | 1.91–4.32 | ||||
| Number of chronic diseases (comorbidities) | < 0.001 | < 0.001 | ||||
| 1 | Ref | |||||
| 2 | 1.59 | 1.41–1.79 | 1.28 | 1.10-1.48 | ||
| 3 or more | 2.11 | 1.88–2.31 | 1.39 | 1.16-1.66 | ||
| Limitations due to chronic disease | < 0.001 | < 0.001 | ||||
| No limitations | Ref | |||||
| Limitations | 1.80 | 1.64–1.97 | 1.34 | 1.21-1.49 | ||
|
| ||||||
| Level 3 | ||||||
|
| ||||||
| Use of drugs | ||||||
| Number of drugs used to treat chronic diseases | < 0,001 | < 0,001 | ||||
| 1 | Ref | |||||
| 2 | 1,28 | 1,12–1,46 | 1,08 | 0,93–1,26 | ||
| 3 to 4 | 1,89 | 1,67–2,12 | 1,43 | 1,21–1,69 | ||
| 5 or more | 2,43 | 2,14–2,76 | 1,61 | 1,34–1,94 | ||
a Non-adherence = low adherence according to BMQ (2 or more positive answers).
b According to the Brief Medication Questionnaire (BMQ).
c Variables grouped by entry in the adjusted analysis model.
d Wald test.
e According to Critério de Classificação Econômica Brasil 2013 – ABEP. Available from: http//www.abep.org.