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Low adherence with antihypertensives in actual practice: the association with social participation - a multilevel analysis

Johnell, K; Råstam, Lennart LU ; Lithman, T; Sundquist, J and Merlo, Juan LU (2005) In BMC Public Health 5(17).
Abstract
Background: Low adherence is a key factor in explaining impaired effectiveness and efficiency in the pharmacological treatment of hypertension. However, little is known about which factors determine low adherence in actual practice. The purpose of this study is to examine whether low social participation is associated with low adherence with antihypertensive medication, and if this association is modified by the municipality of residence. Methods: 1288 users of antihypertensive medication were identified from The Health Survey in Scania 2000, Sweden. The outcome was low adherence with antihypertensives during the last two weeks. Multilevel logistic regression with participants at the first level and municipalities at the second level was... (More)
Background: Low adherence is a key factor in explaining impaired effectiveness and efficiency in the pharmacological treatment of hypertension. However, little is known about which factors determine low adherence in actual practice. The purpose of this study is to examine whether low social participation is associated with low adherence with antihypertensive medication, and if this association is modified by the municipality of residence. Methods: 1288 users of antihypertensive medication were identified from The Health Survey in Scania 2000, Sweden. The outcome was low adherence with antihypertensives during the last two weeks. Multilevel logistic regression with participants at the first level and municipalities at the second level was used for analyses of the data. Results: Low social participation was associated with low adherence with antihypertensives during the last two weeks (OR = 2.05, 95% CI: 1.05-3.99), independently of low educational level. However, after additional adjustment for poor self-rated health and poor psychological health, the association between low social participation and low adherence with antihypertensives during the last two weeks remained but was not conclusive (OR = 1.80, 95% CI: 0.90-3.61). Furthermore, the association between low social participation and low adherence with antihypertensives during the last two weeks varied among municipalities in Scania (i.e., cross-level interaction). Conclusion: Low social participation seems to be associated with low adherence with antihypertensives during the last two weeks, and this association may be modified by the municipality of residence. Future studies aimed at investigating health-related behaviours in general and low adherence with medication in particular might benefit if they consider area of residence. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Public Health
volume
5
issue
17
publisher
BioMed Central
external identifiers
  • wos:000227317300001
  • pmid:15720716
  • scopus:18944377200
ISSN
1471-2458
DOI
10.1186/1471-2458-5-17
language
English
LU publication?
yes
id
37f95f2d-1593-403e-a8d1-6344dfc62c08 (old id 912173)
date added to LUP
2008-01-16 11:54:14
date last changed
2017-01-01 07:13:44
@article{37f95f2d-1593-403e-a8d1-6344dfc62c08,
  abstract     = {Background: Low adherence is a key factor in explaining impaired effectiveness and efficiency in the pharmacological treatment of hypertension. However, little is known about which factors determine low adherence in actual practice. The purpose of this study is to examine whether low social participation is associated with low adherence with antihypertensive medication, and if this association is modified by the municipality of residence. Methods: 1288 users of antihypertensive medication were identified from The Health Survey in Scania 2000, Sweden. The outcome was low adherence with antihypertensives during the last two weeks. Multilevel logistic regression with participants at the first level and municipalities at the second level was used for analyses of the data. Results: Low social participation was associated with low adherence with antihypertensives during the last two weeks (OR = 2.05, 95% CI: 1.05-3.99), independently of low educational level. However, after additional adjustment for poor self-rated health and poor psychological health, the association between low social participation and low adherence with antihypertensives during the last two weeks remained but was not conclusive (OR = 1.80, 95% CI: 0.90-3.61). Furthermore, the association between low social participation and low adherence with antihypertensives during the last two weeks varied among municipalities in Scania (i.e., cross-level interaction). Conclusion: Low social participation seems to be associated with low adherence with antihypertensives during the last two weeks, and this association may be modified by the municipality of residence. Future studies aimed at investigating health-related behaviours in general and low adherence with medication in particular might benefit if they consider area of residence.},
  author       = {Johnell, K and Råstam, Lennart and Lithman, T and Sundquist, J and Merlo, Juan},
  issn         = {1471-2458},
  language     = {eng},
  number       = {17},
  publisher    = {BioMed Central},
  series       = {BMC Public Health},
  title        = {Low adherence with antihypertensives in actual practice: the association with social participation - a multilevel analysis},
  url          = {http://dx.doi.org/10.1186/1471-2458-5-17},
  volume       = {5},
  year         = {2005},
}