Disparities in Antihypertensive Medication Adherence in Persons With Disabilities and Without Disabilities: Results of a Korean Population-Based Study
Abstract
Park JH, Park JH, Lee SY, Kim SY, Shin Y, Kim SY. Disparities in antihypertensive medication adherence in persons with disabilities and without disabilities: results of a Korean population-based study.
Objective
To determine disparities in antihypertensive medication adherence between persons with disabilities and those without disabilities in South Korea.
Design
The study compared antihypertensive medication adherence between persons with disabilities and those without disabilities using medical claims data of the National Health Insurance (NHI).
Setting
We obtained data from claims submitted to the NHI, which covers almost the entire Korean population. Persons who were prescribed antihypertensive medication during the calendar year 2004 were identified.
Participants
The study comprised data from persons with disabilities (n=85,098) and persons without disabilities (n=2,368,636).
Interventions
Not applicable.
Main Outcome Measures
A cumulative medication adherence (CMA) greater than or equal to 80% was defined as an appropriate medication adherence. Multiple logistic regression was used to identify differences in antihypertensive medication adherence between persons with disabilities and without disabilities. Estimates were adjusted for demographic characteristics (sex, age), type of medical insurance, insurance contribution a month as a proxy for household income, residential area, and clinical characteristics (medication duration, comorbid conditions).
Results
People with disabilities had lower CMAs than those without (median CMA, 83.6% vs 85.7%; appropriate medication adherence, 54.5% vs 57.5%). Results of the multiple logistic regression adjusting other factors indicated that people with disabilities had decreased probabilities of appropriate adherence.
Conclusions
Medication adherence is reduced by various types of disability and impairment such as those involving mobility and communication. Much effort should be made to investigate how and why these disparities take place and develop health policies to remove these disparities if they exist.
aCancer Policy and Management Branch, National Cancer Center, Cheju, Korea
bDepartment of Preventive Medicine, Cheju University College of Medicine, Cheju, Korea
cDepartment of Healthcare Industry, Korea Health Industry Development Institute, Seoul, Korea
dDepartment of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
eDepartment of Preventive Medicine, Cheju University College of Medicine, Jeju, Korea.
Reprint requests to Jae Hyun Park, MD, PhD, MPH, National Cancer Center, 809 Madu1-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Korea
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
ABSTRACT