Table 6.
Factors Associated With Medication Nonadherence Among 187 African Americans Admitted to an Urban Hospital With Severe, Poorly Controlled Hypertension a
| Missed Medication Prior to Admission, OR (95% CI) | Nonadherence: Prescription Refill, OR (95% CI) | Nonadherence: Pill Taking, OR (95% CI) | |
|---|---|---|---|
| Age (per 10 y) | 0.83 (0.63, 1.10) | 1.11 (0.83, 1.47) | 0.99 (0.76, 1.30) |
| Men (women as reference) | 1.19 (0.59, 2.40) | 1.57 (0.79, 3.11) | 0.54 (0.28, 1.04) |
| Disease characteristics | |||
| Heroin and/or cocaine use | 1.69 (0.77, 3.69) | 1.50 (0.72, 3.11) | 0.72 (0.36, 1.47) |
| Mortality risk category | |||
| Level 1 “minor” | Reference | Reference | Reference |
| Level 2 “moderate” | 0.59 (0.25, 1.40) | 0.99 (0.43, 2.29) | 1.00 (0.46, 2.21) |
| Level 3/4 “major” and “extreme” | 0.36 (0.12, 1.11) | 1.04 (0.32, 3.37) | 0.73 (0.24, 2.16) |
| P value for trend | .202 | .994 | .797 |
| Disease complexity category | |||
| Level 1 “minor” | Reference | Reference | Reference |
| Level 2 “moderate” | 0.40 (0.08, 2.03) | 0.70 (0.21, 2.37) | 2.35 (0.68, 8.16) |
| Level 3/4 “major” and “extreme” | 0.45 (0.08, 2.64) | 0.79 (0.19, 3.29) | 3.37 (0.82, 13.9) |
| P value for trend | .537 | .833 | .242 |
| Access to care variables | |||
| Insurance status | |||
| Insured with full medication coverage | Reference | Reference | Reference |
| Insured with medication copay | 1.04 (0.44, 2.44) | 1.05 (0.38, 2.96) | 0.40 (0.17, 0.98) |
| Insured without medication coverage | 2.48 (0.59, 10.4) | 1.01 (0.24, 4.17) | 1.09 (0.31, 3.79) |
| Uninsured | 2.90 (1.05, 8.00) | 4.51 (1.76, 11.5) | 0.52 (0.21, 1.29) |
| P value for trend | .103 | .002 | .169 |
| Can't afford medications | 4.90 (2.01, 12.0) | 4.12 (1.88, 9.03) | 0.77 (0.37, 1.59) |
| Can't find doctor to prescribe | 2.41 (0.66, 8.73) | 1.02 (0.40, 2.59) | 1.67 (0.66, 4.21) |
| Can't get to pharmacy | 1.10 (0.43, 2.78) | 1.64 (0.70, 3.86) | 0.94 (0.40, 2.18) |
| Knowledge, attitudes, and beliefs | |||
| Hypertension knowledge (fewer than 80% correct) | 0.78 (0.35, 1.77) | 0.91 (0.42, 1.95) | 2.97 (1.39, 6.32) |
| Experience side effects | 0.86 (0.34, 2.17) | 0.68 (0.28, 1.64) | 3.44 (1.47, 8.03) |
| Forget to take medicine | 1.66 (0.78, 3.52) | 0.32 (1.44, 0.71) | 3.62 (1.78, 7.34) |
| Blood pressure pills don't help | 1.19 (0.41, 3.48) | 1.26 (0.50, 3.16) | 2.78 (1.09, 7.09) |
| Take pills too many times per day | 7.15 (0.86, 59.7) | 0.42 (0.12, 1.46) | 3.82 (1.16, 12.5) |
aAdjusting for disease severity and other adherence factors. Bold values indicates P<.05.