A cohort study of possible risk factors for over-reporting of antihypertensive adherence

Peter W. Choo, Cynthia S. Rand, Thomas Inui, Mei Ling Ting Lee, Claire Canning, Richard Platt

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: The identification of poor medicinal adherence is difficult because direct observation of medication use is usually impractical. Up to 50% of individuals on chronic therapies may not be taking their medication as prescribed. This study is one of the first to explore possible risk factors for over-reporting of antihypertensive adherence using electronic medication monitoring. Methods: The adherence of 286 individuals on single-drug antihypertensive therapy in a large managed care organization was electronically monitored for approximately three months. Questionnaires on socioeconomic background, adherence to therapy, health beliefs, and social support before and after adherence monitoring were completed. Over-reporting of antihypertensive adherence was assessed by comparing the self-reported frequency of noncompliance with that determined from electronic dosing records. Risk factors for overreporting were identified by contingency table analysis and step-wise logistic regression. Results: Although only 21% of participants acknowledged missing doses on one or more days per week, electronic monitoring documented nonadherence at this or a higher level in 42% of participants. The following variables were associated with over-reporting: >1 versus 1 daily dose (OR = 2.58; 95% CI = 1.50-4.41; p = .0006), lower perceived health risk from nonadherence (OR = 1.35; 95% CI = 1.10-1.64; p = .0035), and annual household income of $ 30,000 (OR = 2.64; 95% CI = 1.13-6.18; p = .025). Conclusions: Over-reporting of adherence may be affected by factors related to dosing frequency, health beliefs and socioeconomic status. This topic deserves further investigation in other patient populations to elucidate possible underlying behavioral explanations.

Original languageEnglish (US)
Article number6
JournalBMC cardiovascular disorders [electronic resource]
Volume1
DOIs
StatePublished - Dec 13 2001
Externally publishedYes

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Antihypertensive Agents
Cohort Studies
Health
Managed Care Programs
Social Class
Social Support
Health Status
Logistic Models
Observation
Organizations
Drug Therapy
Therapeutics
Population
Surveys and Questionnaires

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

A cohort study of possible risk factors for over-reporting of antihypertensive adherence. / Choo, Peter W.; Rand, Cynthia S.; Inui, Thomas; Ting Lee, Mei Ling; Canning, Claire; Platt, Richard.

In: BMC cardiovascular disorders [electronic resource], Vol. 1, 6, 13.12.2001.

Research output: Contribution to journalArticle

Choo, Peter W. ; Rand, Cynthia S. ; Inui, Thomas ; Ting Lee, Mei Ling ; Canning, Claire ; Platt, Richard. / A cohort study of possible risk factors for over-reporting of antihypertensive adherence. In: BMC cardiovascular disorders [electronic resource]. 2001 ; Vol. 1.
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abstract = "Background: The identification of poor medicinal adherence is difficult because direct observation of medication use is usually impractical. Up to 50{\%} of individuals on chronic therapies may not be taking their medication as prescribed. This study is one of the first to explore possible risk factors for over-reporting of antihypertensive adherence using electronic medication monitoring. Methods: The adherence of 286 individuals on single-drug antihypertensive therapy in a large managed care organization was electronically monitored for approximately three months. Questionnaires on socioeconomic background, adherence to therapy, health beliefs, and social support before and after adherence monitoring were completed. Over-reporting of antihypertensive adherence was assessed by comparing the self-reported frequency of noncompliance with that determined from electronic dosing records. Risk factors for overreporting were identified by contingency table analysis and step-wise logistic regression. Results: Although only 21{\%} of participants acknowledged missing doses on one or more days per week, electronic monitoring documented nonadherence at this or a higher level in 42{\%} of participants. The following variables were associated with over-reporting: >1 versus 1 daily dose (OR = 2.58; 95{\%} CI = 1.50-4.41; p = .0006), lower perceived health risk from nonadherence (OR = 1.35; 95{\%} CI = 1.10-1.64; p = .0035), and annual household income of $ 30,000 (OR = 2.64; 95{\%} CI = 1.13-6.18; p = .025). Conclusions: Over-reporting of adherence may be affected by factors related to dosing frequency, health beliefs and socioeconomic status. This topic deserves further investigation in other patient populations to elucidate possible underlying behavioral explanations.",
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