Document Type
Article
Publication Date
1-1-2021
Publication Title
Journal of Hypertension
Issue
1
Pages
1-9
Publisher Name
Wolters Kluwer Health, Inc.
Abstract
Objective: The aim of this study was to determine the association of low antihypertensive medication adherence with decline in health-related quality of life (HRQOL) over 1 year.
Methods: We used data from older men and women with hypertension (n¼ 1525) enrolled in the Cohort Study of Medication Adherence among Older Adults. Adherence was measured using the validated self-report four-item Krousel-Wood Medication Adherence Scale (K-Wood-MAS-4) (low adherence¼ score 1) and prescription refill-based proportion of days covered (PDC) (low adherence¼ PDC< 0.80). We defined decline in HRQOL as a decrease in Mental Component Summary (MCS) or Physical Component Summary (PCS) score (from the RAND 36-Item Health Survey 1.0 administered at two time points – at the time of adherence assessment and 1 year later) equivalent to the minimal important difference (MID) for each respective summary score, calculated as the average of MID estimates derived from distribution and anchor-based approaches.
Results: The prevalence of low adherence was 38.6% using the K-Wood-MAS-4 and 23.9% using PDC. On the basis of mean MID estimates of 4.40 for MCS and 5.16 for PCS, 21.8 and 25.2% of participants experienced a decline in MCS and PCS, respectively, over 1 year. Low adherence was associated with a decline in MCS for K-Wood-MAS-4 [prevalence ratio ¼ 1.32, 95% confidence interval (95% CI) 1.08–1.62, P ¼ 0.008], but not PDC (prevalence ratio ¼ 1.17, 95% CI 0.94–1.47, P ¼ 0.168). Low adherence was not associated with decline in PCS (K-Wood-MAS-4: prevalence ratio ¼ 0.95, 95% CI 0.79–1.16; PDC: prevalence ratio ¼ 1.10, 95% CI 0.90–1.35).
Conclusion: Low self-report medication adherence is associated with decline in mental HRQOL over 1 year in older adults with hypertension.
Recommended Citation
Peacock, Erin; Joyce, Cara; Craig, Leslie S.; Lenane, Zachary; Holt, Elizabeth W.; Muntner, Paul; and Krousel-Wood, Marie, "Low medication adherence is associated with decline in health-related quality of life: results of a longitudinal analysis among older women and men with hypertension" (2021). Biostatistics Collaborative Core: Faculty Publications and Other Works. 37.
https://ecommons.luc.edu/biostatistics_facpubs/37
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Copyright Statement
© The Author(s), 2020.
Comments
Author Posting © The Author(s), 2020. This article is posted here by permission of Wolters Kluwer Health, Inc. for personal use, not for redistribution. This article was published open access in Journal of Hypertension, Vol. 39, Iss. 1 (January 2021), https://doi.org/10.1097/HJH.0000000000002590.