TABLE 3.
Factors Associated With Low Medication Adherence: Multivariate Models
| Category | Factor | Full Model |
Reduced Modela |
Final Modelb |
|||
|---|---|---|---|---|---|---|---|
| OR (95% Cl) | p value | OR (95% Cl) | p value | OR (95% Cl) | p value | ||
| Depression | Depressive symptoms (ref: minimal) | ||||||
| Mild | 2.28 (1.34–3.85) | 0.0022 | 2.42 (1.50–3.92) | 0.001 | 2.67(1.76–4.04) | <0.0001 | |
| Moderate | 2.26 (1.16–4.39) | 0.016 | 2.46 (1.35–4.49) | 0.0025 | 3.34 (2.06–5.42) | <0.0001 | |
| Moderately severe/Severe | 3.02 (1.40–6.51) | 0.0008 | 2.70 (1.37–5.29) | 0.0001 | 4.22 (2.53–7.04) | <0.0001 | |
| Self-efficacy (1-unit ↓) | 1.00(0.91–1.11) | 0.97 | 1.01 (0.93–1.11) | 0.76 | |||
| Individual | Poor satisfaction with care | 0.89 (0.45–1.75) | 0.74 | 1.13 (0.61–2.08) | 0.69 | ||
| factors | Sex (female) | 2.58 (1.12–5.95) | 0.026 | 2.65 (1.27–5.52) | 0.0094 | 3.19(1.61–6.31) | 0.0009 |
| Age (1-year ↓) | 1.03 (1.01–1.05) | 0.0038 | 1.03 (1.01–1.04) | 0.0004 | 1.02(1.01–1.03) | 0.0048 | |
| SES and healthcare factor | Education (3-year ↑) | 1.23 (0.96–1.58) | 0.11 | ||||
| Uninsured or underinsured factors | 1.06(0.66–1.70) | 0.82 | |||||
| Living below the poverty line | 1.01 (0.60–1.70) | 0.96 | |||||
| Single or living alone | 1.04 (0.67–1.63) | 0.86 | |||||
| Patient-physician communication: | |||||||
| Hurried communication (1-unit ↑) | 1.12(0.76–1.66) | 0.57 | 1.11 (0.79–1.55) | 0.56 | |||
| Shared decision-making (1-unit ↓) | 1.22(0.94–1.57) | 0.13 | 1.17(0.94–1.46) | 0.16 | |||
| Compassioned style (1-unit ↓) | 0.92(0.59–1.42) | 0.7 | 1.02 (0.68–1.51) | 0.93 | |||
| Visited mental health | 0.71 (0.39–1.30) | 0.27 | |||||
| providers in past year | |||||||
| Disease-related factors | Poor/fair health | 1.06 (0.66–1.69) | 0.81 | 0.96(0.63–1.44) | 0.83 | ||
| Disease activity score (3-unit ↑) | 1.09(0.99–1.19) | 0.076 | 1.05 (0.96–1.13) | 0.28 | |||
| Severe organ damage | 0.90(0.59–1.37) | 0.62 | |||||
| No. medications (1-unit ↑) | 0.92 (0.80–1.05) | 0.2 | |||||
The symbols ↑ and ↓ in parenthesis do not represent longitudinal change of scores; they denote the model's response to the indicated changes in covariates.
a
Reduced model included factors with p value < 0.2 in univariate logistic analysis.
b
The final model was based on bootstrap analysis using forward stepwise logistic regression with an entry criterion of p value < 0.20 and a retention criterion of p value <0.05. The final model provided a very good fit of the data (Hosmer-Lemeshow goodness-of-fit test, p = 0.94).