Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 8 , Pages 1460-1467, August 2008

Disparities in Antihypertensive Medication Adherence in Persons With Disabilities and Without Disabilities: Results of a Korean Population-Based Study

  • Jong Hyock Park, MD, MPH

      Affiliations

    • Cancer Policy and Management Branch, National Cancer Center, Cheju, Korea
    • ,
  • Jae Hyun Park, MD, PhD, MPH

      Affiliations

    • Cancer Policy and Management Branch, National Cancer Center, Cheju, Korea
    • Corresponding Author InformationReprint requests to Jae Hyun Park, MD, PhD, MPH, National Cancer Center, 809 Madu1-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Korea
    • ,
  • Sang Yi Lee, MD, PhD

      Affiliations

    • Department of Preventive Medicine, Cheju University College of Medicine, Cheju, Korea
    • ,
  • So Young Kim, MD

      Affiliations

    • Department of Healthcare Industry, Korea Health Industry Development Institute, Seoul, Korea
    • Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
    • ,
  • Youngsoo Shin, MD, DrPH, MPH

      Affiliations

    • Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
    • ,
  • Su Young Kim, PhD

      Affiliations

    • Department of Preventive Medicine, Cheju University College of Medicine, Jeju, Korea.

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.

Key Words: Antihypertensive agents, Disabled persons, Patient compliance, Rehabilitation

List of Abbreviations: ADLs, activities of daily living, AOR, adjusted odds ratio, CI, confidence interval, CMA, cumulative medication adherence, KDA, Korean Disability Act, NHI, National Health Insurance

 

 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.

PII: S0003-9993(08)00380-8

doi:10.1016/j.apmr.2007.12.045

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 8 , Pages 1460-1467, August 2008

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