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Sex Differences in Barriers to Antihypertensive Medication Adherence: Findings from the Cohort Study of Medication Adherence Among Older Adults
Author(s) -
Holt Elizabeth,
Joyce Cara,
Dornelles Adriana,
Morisky Donald,
Webber Larry S.,
Muntner Paul,
KrouselWood Marie
Publication year - 2013
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12171
Subject(s) - medicine , psychosocial , confidence interval , odds ratio , cohort , medication adherence , body mass index , cohort study , blood pressure , cross sectional study , psychiatry , pathology
Objectives To determine whether sociodemographic, clinical, healthcare system, psychosocial, and behavioral factors are differentially associated with low antihypertensive medication adherence scores in older men and women. Design Cross‐sectional analysis of baseline data. Setting Cohort S tudy of M edication A dherence in O lder A dults (N = 2,194). Measurements Low antihypertensive medication adherence was defined as a score less than 6 on the 8‐item M orisky M edication A dherence S cale. Information on risk factors for low adherence was collected using telephone surveys and administrative databases. Results The prevalence of low medication adherence scores did not differ according to sex (women, 15.0%; men 13.1%; P = .21). In sex‐specific multivariable models, having problems with medication cost and practicing fewer lifestyle modifications for blood pressure control were associated with low adherence scores in men and women. Factors associated with low adherence scores in men but not women were poor sexual functioning (odds ratio ( OR ) = 2.03, 95% confidence interval ( CI ) = 1.31–3.16 for men and OR = 1.28, 95% CI = 0.90–1.82 for women), and body mass index of 25.0 kg/m 2 or more ( OR = 3.23, 95% CI = 1.59–6.59 for men; OR = 1.23, 95% CI = 0.82–1.85 for women). Factors associated with low adherence scores in women but not men included dissatisfaction with communication with their healthcare provider ( OR = 1.75, 95% CI = 1.16–2.65 for women; OR = 1.16, 95% CI = 0.57–2.34 for men) and depressive symptoms ( OR = 2.29, 95% CI = 1.55–3.38 for women; OR = 0.93, 95% CI = 0.48–1.80 for men). Conclusion Factors associated with low antihypertensive medication adherence scores differed according to sex. Interventions designed to improve adherence in older adults should be customized to account for the sex of the target population.