Risk Factors and the Usual Source of Care on Non-Adherence to Antihypertensive Drugs in Immigrants with Hypertension
Hyemin Cho,1,* Sohyun Jeong,2,3,* Cinoo Kang,4 Hee-Jin Kang,1 Suhyun Jang,1 Sunmee Jang1 1College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Republic of Korea; 2Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA; 3Department of Medic...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-11-01
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| Series: | Patient Preference and Adherence |
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| Online Access: | https://www.dovepress.com/risk-factors-and-the-usual-source-of-care-on-non-adherence-to-antihype-peer-reviewed-article-PPA |
| _version_ | 1818325007098445824 |
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| author | Cho H Jeong S Kang C Kang HJ Jang S Jang S |
| author_facet | Cho H Jeong S Kang C Kang HJ Jang S Jang S |
| author_sort | Cho H |
| collection | DOAJ |
| description | Hyemin Cho,1,* Sohyun Jeong,2,3,* Cinoo Kang,4 Hee-Jin Kang,1 Suhyun Jang,1 Sunmee Jang1 1College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Republic of Korea; 2Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA; 3Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; 4Department of Biostatics and Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea*These authors contributed equally to this workCorrespondence: Sunmee JangCollege of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, 191 Hambakmoero, Yeonsu-Gu, Incheon 21936, South KoreaTel +82-32-820-4941Fax +82-32-820-4829Email smjang@gachon.ac.krBackground: Immigrants are vulnerable to suboptimal health care utilization including non-adherence of medication use. Thus, we aimed to identify the potential risk factors of non-adherence and evaluate whether utilizing a usual source of care was associated with medication adherence in immigrants.Methods: We utilized the Korea National Health Insurance Claims Database between 2012 and 2015. Cases were immigrants who had antihypertensive prescriptions at the time of hypertension diagnosis in 2012. Controls were native-born Koreans with hypertension who were 1:1 matched to immigrants by age, sex, and Charlson comorbidity index. We used the medication possession ratio for three years to assess the adherence to antihypertensive drugs. The likelihood of non-adherence was evaluated between cases and controls by multivariate linear regression models stratified by age, sex, and number of clinic visits. We assessed the potential risk factors of non-adherence in immigrants by multivariate linear regression and logistic regression models, respectively.Results: In total, 4114 immigrants and 4114 matched native-born Koreans with hypertension were included. The mean MPR was significantly lower in immigrants (56% vs 70%, p< 0.0001). Immigrants showed almost two times the level of non-adherence as native-born Koreans (odds ratio [OR], 2.01; 95% confidence interval [CI], 1.83– 2.21). Stratified analyses on non-adherence presented the highest non-adherence (2.28 times) in immigrants in the younger group (30– 49 years old) and the lowest non-adherence in immigrants in 65 and old group where the risk was 1.69 times higher than native Korean with the same age. The absence of a usual source of care significantly increased medication non-adherence by 1.31 to 1.58 times among immigrants.Conclusion: When the number of visited clinics increased, the degree of non-adherence increased consistently. Therefore, the systematization of registering with primary care (a usual source of care) might be a modifiable health care strategy to improve health care outcomes in immigrants.Keywords: usual source of care, hypertension, immigrants, health care strategy |
| first_indexed | 2024-12-13T11:37:38Z |
| format | Article |
| id | doaj.art-f30bd517589a405c9afbce6fe38d5a96 |
| institution | Directory Open Access Journal |
| issn | 1177-889X |
| language | English |
| last_indexed | 2024-12-13T11:37:38Z |
| publishDate | 2020-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Patient Preference and Adherence |
| spelling | doaj.art-f30bd517589a405c9afbce6fe38d5a962022-12-21T23:47:44ZengDove Medical PressPatient Preference and Adherence1177-889X2020-11-01Volume 142123213358847Risk Factors and the Usual Source of Care on Non-Adherence to Antihypertensive Drugs in Immigrants with HypertensionCho HJeong SKang CKang HJJang SJang SHyemin Cho,1,* Sohyun Jeong,2,3,* Cinoo Kang,4 Hee-Jin Kang,1 Suhyun Jang,1 Sunmee Jang1 1College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Republic of Korea; 2Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA; 3Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; 4Department of Biostatics and Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea*These authors contributed equally to this workCorrespondence: Sunmee JangCollege of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, 191 Hambakmoero, Yeonsu-Gu, Incheon 21936, South KoreaTel +82-32-820-4941Fax +82-32-820-4829Email smjang@gachon.ac.krBackground: Immigrants are vulnerable to suboptimal health care utilization including non-adherence of medication use. Thus, we aimed to identify the potential risk factors of non-adherence and evaluate whether utilizing a usual source of care was associated with medication adherence in immigrants.Methods: We utilized the Korea National Health Insurance Claims Database between 2012 and 2015. Cases were immigrants who had antihypertensive prescriptions at the time of hypertension diagnosis in 2012. Controls were native-born Koreans with hypertension who were 1:1 matched to immigrants by age, sex, and Charlson comorbidity index. We used the medication possession ratio for three years to assess the adherence to antihypertensive drugs. The likelihood of non-adherence was evaluated between cases and controls by multivariate linear regression models stratified by age, sex, and number of clinic visits. We assessed the potential risk factors of non-adherence in immigrants by multivariate linear regression and logistic regression models, respectively.Results: In total, 4114 immigrants and 4114 matched native-born Koreans with hypertension were included. The mean MPR was significantly lower in immigrants (56% vs 70%, p< 0.0001). Immigrants showed almost two times the level of non-adherence as native-born Koreans (odds ratio [OR], 2.01; 95% confidence interval [CI], 1.83– 2.21). Stratified analyses on non-adherence presented the highest non-adherence (2.28 times) in immigrants in the younger group (30– 49 years old) and the lowest non-adherence in immigrants in 65 and old group where the risk was 1.69 times higher than native Korean with the same age. The absence of a usual source of care significantly increased medication non-adherence by 1.31 to 1.58 times among immigrants.Conclusion: When the number of visited clinics increased, the degree of non-adherence increased consistently. Therefore, the systematization of registering with primary care (a usual source of care) might be a modifiable health care strategy to improve health care outcomes in immigrants.Keywords: usual source of care, hypertension, immigrants, health care strategyhttps://www.dovepress.com/risk-factors-and-the-usual-source-of-care-on-non-adherence-to-antihype-peer-reviewed-article-PPAusual source of carehypertensionimmigrantshealth care strategy |
| spellingShingle | Cho H Jeong S Kang C Kang HJ Jang S Jang S Risk Factors and the Usual Source of Care on Non-Adherence to Antihypertensive Drugs in Immigrants with Hypertension Patient Preference and Adherence usual source of care hypertension immigrants health care strategy |
| title | Risk Factors and the Usual Source of Care on Non-Adherence to Antihypertensive Drugs in Immigrants with Hypertension |
| title_full | Risk Factors and the Usual Source of Care on Non-Adherence to Antihypertensive Drugs in Immigrants with Hypertension |
| title_fullStr | Risk Factors and the Usual Source of Care on Non-Adherence to Antihypertensive Drugs in Immigrants with Hypertension |
| title_full_unstemmed | Risk Factors and the Usual Source of Care on Non-Adherence to Antihypertensive Drugs in Immigrants with Hypertension |
| title_short | Risk Factors and the Usual Source of Care on Non-Adherence to Antihypertensive Drugs in Immigrants with Hypertension |
| title_sort | risk factors and the usual source of care on non adherence to antihypertensive drugs in immigrants with hypertension |
| topic | usual source of care hypertension immigrants health care strategy |
| url | https://www.dovepress.com/risk-factors-and-the-usual-source-of-care-on-non-adherence-to-antihype-peer-reviewed-article-PPA |
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