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Socioeconomic disadvantage and primary non-adherence with medication in Sweden

Wamala, Sarah; Merlo, Juan LU ; Bostrom, Gunnel; Hogstedt, Christer and Agren, Gunner (2007) In International Journal for Quality in Health Care 19(3). p.134-140
Abstract
Objective. Lack of adherence with pharmacological therapy is a public health concern that compels tremendous costs for the health care system and the community. To analyse the association between socioeconomic disadvantage and primary nonadherence with medication, and to explore possible mediating effects of trust in health care and lifestyle profile. Design. Cross-sectional population-based study based on data from the Swedish national public health surveys 2004-2005. Participants. The study comprised 13603 men and 18292 women aged 21-84 years who had any contact with a physician at a hospital or primary care centre. Measures. Primary non-adherence with medication based on whether respondents reported that they refrained from purchasing... (More)
Objective. Lack of adherence with pharmacological therapy is a public health concern that compels tremendous costs for the health care system and the community. To analyse the association between socioeconomic disadvantage and primary nonadherence with medication, and to explore possible mediating effects of trust in health care and lifestyle profile. Design. Cross-sectional population-based study based on data from the Swedish national public health surveys 2004-2005. Participants. The study comprised 13603 men and 18292 women aged 21-84 years who had any contact with a physician at a hospital or primary care centre. Measures. Primary non-adherence with medication based on whether respondents reported that they refrained from purchasing at the pharmacy prescribed medication. Socioeconomic Disadvantage Index was based on four different indicators of economic deprivation. Results. Socioeconomic disadvantage was associated with primary non-adherence with medication independent of long-term illness, risky lifestyle, low education, living alone and low trust for health care. This association increased with older age, particularly among women. Among individuals aged 21-34 years, severe compared with no socioeconomic disadvantage, was associated with two-fold increased odds for non-adherence with medication. The: corresponding odds among individuals aged 65-84 years were three-fold increase among elderly men (OR = 3.3, 95% CI: 1.4-7.8) and six-fold increase among elderly women (OR = 6.2, 95% CI: 2.5-15.3). Yet every seventh elderly woman aged 65-84 years suffered from long-term illness. Conclusions. Results indicate that health policies for 'care on equal terms' in Sweden have been less successful in relation to equitable access to prescribed medication, especially among the elderly. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
non-adherence, socioeconomic disadvantage, elderly, medication, gender, socioeconomic inequalities
in
International Journal for Quality in Health Care
volume
19
issue
3
pages
134 - 140
publisher
Oxford University Press
external identifiers
  • wos:000247094700003
  • scopus:34447559796
ISSN
1464-3677
DOI
10.1093/intqhc/mzm011
language
English
LU publication?
yes
id
af0d0d9e-a182-4c8e-9052-1dc965376f1e (old id 651045)
date added to LUP
2008-01-03 10:19:56
date last changed
2017-09-17 07:21:16
@article{af0d0d9e-a182-4c8e-9052-1dc965376f1e,
  abstract     = {Objective. Lack of adherence with pharmacological therapy is a public health concern that compels tremendous costs for the health care system and the community. To analyse the association between socioeconomic disadvantage and primary nonadherence with medication, and to explore possible mediating effects of trust in health care and lifestyle profile. Design. Cross-sectional population-based study based on data from the Swedish national public health surveys 2004-2005. Participants. The study comprised 13603 men and 18292 women aged 21-84 years who had any contact with a physician at a hospital or primary care centre. Measures. Primary non-adherence with medication based on whether respondents reported that they refrained from purchasing at the pharmacy prescribed medication. Socioeconomic Disadvantage Index was based on four different indicators of economic deprivation. Results. Socioeconomic disadvantage was associated with primary non-adherence with medication independent of long-term illness, risky lifestyle, low education, living alone and low trust for health care. This association increased with older age, particularly among women. Among individuals aged 21-34 years, severe compared with no socioeconomic disadvantage, was associated with two-fold increased odds for non-adherence with medication. The: corresponding odds among individuals aged 65-84 years were three-fold increase among elderly men (OR = 3.3, 95% CI: 1.4-7.8) and six-fold increase among elderly women (OR = 6.2, 95% CI: 2.5-15.3). Yet every seventh elderly woman aged 65-84 years suffered from long-term illness. Conclusions. Results indicate that health policies for 'care on equal terms' in Sweden have been less successful in relation to equitable access to prescribed medication, especially among the elderly.},
  author       = {Wamala, Sarah and Merlo, Juan and Bostrom, Gunnel and Hogstedt, Christer and Agren, Gunner},
  issn         = {1464-3677},
  keyword      = {non-adherence,socioeconomic disadvantage,elderly,medication,gender,socioeconomic inequalities},
  language     = {eng},
  number       = {3},
  pages        = {134--140},
  publisher    = {Oxford University Press},
  series       = {International Journal for Quality in Health Care},
  title        = {Socioeconomic disadvantage and primary non-adherence with medication in Sweden},
  url          = {http://dx.doi.org/10.1093/intqhc/mzm011},
  volume       = {19},
  year         = {2007},
}