Table 4.
Multivariate Associations of MRCI Count with COPD Severity, and Hypertension and Diabetes Control
| High COPD Severity Score* | High MRC Dyspnea Scale Score† | Blood Pressure Not at Target |
Hemoglobin A1c ≥8.0% | |||||
|---|---|---|---|---|---|---|---|---|
| OR (95% CI) | P | OR (95% CI) | P | OR (95% CI) | P | OR (95% CI) | P | |
| MCRI | ||||||||
| 1st quartile | Ref. | Ref. | Ref. | Ref. | ||||
| 2nd quartile | 1.33 (0.33–5.41) | 0.69 | 1.86 (0.89–3.89) | 0.10 | 0.78 (0.41–1.50) | 0.46 | 0.35 (0.05–2.71) | 0.31 |
| 3rd quartile | 2.58 (0.70–9.43) | 0.15 | 1.35 (0.64–2.85) | 0.44 | 1.02 (0.52–2.00) | 0.95 | 1.25 (0.18–8.82) | 0.82 |
| 4th quartile | 5.00 (1.46–17.1) | 0.01 | 2.27 (1.03–5.03) | 0.04 | 0.67 (0.34–1.35) | 0.26 | 1.50 (0.22–10.2) | 0.68 |
| Age Category | ||||||||
| 50-59 | Ref. | Ref. | Ref. | Ref. | ||||
| 60-69 | 1.67 (0.57-4.92) | 0.35 | 0.78 (0.35-1.83) | 0.57 | 2.49 (1.23-5.03) | 0.01 | 1.17 (0.29-4.76) | 0.82 |
| 70-79 | 1.43 (0.44-4.70) | 0.55 | 0.85 (0.35-2.05) | 0.72 | 1.40 (0.68-2.89) | 0.36 | 0.09 (0.01-0.75) | 0.03 |
| 80+ | 1.42 (0.33-8.94) | 0.52 | 2.19 (0.74-6.46) | 0.16 | 0.67 (0.26-1.72) | 0.41 | 1.69 (0.19-15.1) | 0.64 |
| Male Sex | 1.48 (0.66–3.33) | 0.34 | 1.24 (0.71–2.16) | 0.46 | 0.81 (0.50–1.33) | 0.41 | 0.64 (0.18–2.33) | 0.51 |
| Race and ethnicity | ||||||||
| White, non-Hispanic | Ref. | Ref. | Ref. | Ref. | ||||
| Black, non-Hispanic | 1.63 (0.55–4.87) | 0.38 | 2.71 (1.27–5.82) | 0.01 | 0.75 (0.39–1.45) | 0.39 | 1.19 (0.20–7.18) | 0.85 |
| Hispanic | 1.42 (0.36–5.66) | 0.62 | 3.02 (0.98–9.33) | 0.05 | 1.49 (0.59–3.73) | 0.40 | 1.54 (0.23–10.5) | 0.66 |
| Education | ||||||||
| College graduate | Ref. | Ref. | Ref. | Ref. | ||||
| Some college | 1.35 (0.45–4.06) | 0.60 | 1.05 (0.54–2.05) | 0.88 | 0.92 (0.49–1.73) | 0.80 | 1.81 (0.30–11.1) | 0.52 |
| High school graduate | 2.66 (0.85–8.30) | 0.09 | 1.22 (0.56–2.66) | 0.62 | 0.49 (0.29–1.17) | 0.13 | 1.11 (0.14–8.63) | 0.92 |
| Did not graduate high school | 0.17 (0.02–1.70) | 0.13 | 1.44 (0.44–4.76) | 0.55 | 0.80 (0.32–2.05) | 0.65 | 4.62 (0.46–46.0) | 0.19 |
| English proficiency, low | 0.78 (0.07–8.76) | 0.84 | - | 0.30 (0.07–1.28) | 0.10 | 1.62 (0.13–20.8) | 0.71 | |
| Low health literacy | 0.88 (0.32–2.41) | 0.81 | 1.46 (0.64–3.33) | 0.36 | 0.97 (0.50–1.89) | 0.92 | 1.23 (0.29–5.25) | 0.78 |
| Insurance | ||||||||
| Private | Ref. | Ref. | Ref. | Ref. | ||||
| Any Medicaid | 3.44 (1.19–9.94) | 0.02 | 1.87 (0.83–4.22) | 0.13 | 1.08 (0.54–2.15) | 0.83 | 1.05 (0.20–5.48) | 0.95 |
| Medicare | 0.80 (0.18–3.52) | 0.77 | 1.73 (0.72–4.17) | 0.22 | 1.63 (0.75–3.55) | 0.22 | 1.90 (0.23–15.7) | 0.55 |
| Depression | 2.61 (1.05–6.47) | 0.04 | 2.36 (1.04–5.31) | 0.04 | 0.59 (0.30–1.17) | 0.13 | 0.50 (0.10–2.39) | 0.38 |
| Executive function impairment | 0.67 (0.17–2.68) | 0.57 | 0.96 (0.35–2.66) | 0.94 | 0.77 (0.35–1.69) | 0.51 | 2.99 (0.46–19.4) | 0.25 |
Notes: *COPD severity score >1 standard deviation above the mean value for the study sample. †MRC Dyspnea Scale score >3.
Abbreviations: COPD, chronic obstructive pulmonary disease; MRC, Medical Research Council; MRCI, medication regimen complexity index.