Sex Differences in Barriers to Antihypertensive Medication Adherence: Findings from the Cohort Study of Medication Adherence Among Older Adults

Abstract

Objectives We assessed whether socio-demographic, clinical, health care system, psychosocial, and behavioral factors are differentially associated with low antihypertensive medication adherence scores among older men and women. Design / Setting A cross-sectional analysis using baseline data from the Cohort Study of Medication Adherence in Older Adults (CoSMO, n=2,194). Measurements Low antihypertensive medication adherence was defined as a score <6 on the 8-item Morisky Medication Adherence Scale. Risk factors for low adherence were collected using telephone surveys and administrative databases. Results The prevalence of low medication adherence scores did not differ according to sex (15.0% in women and 13.1% in men p=0.208). In sex-specific multivariable models, having issues with medication cost and practicing fewer lifestyle modifications for blood pressure control were associated with low adherence scores among both men and women. Factors associated with low adherence scores in men but not women included reduced sexual functioning (OR = 2.03; 95% CI: 1.31, 3.16 for men and OR = 1.28; 95% CI: 0.90, 1.82 for women), and BMI ≥25 (OR = 3.23; 95% CI: 1.59, 6.59 for men and 1.23; 95% CI: 0.82, 1.85 for women). Factors associated with low adherence scores in women but not men included dissatisfaction with communication with their healthcare provider (OR = 1.75; 95% CI: 1.16, 2.65 for women and OR =1.16 95% CI: 0.57, 2.34 for men) and depressive symptoms (OR = 2.29; 95% CI: 1.55, 3.38 for women and OR = 0.93; 95% CI: 0.48, 1.80 for men). Conclusion Factors associated with low antihypertensive medication adherence scores differed according to sex. Interventions designed to improve adherence in older adults should be tailored to account for the sex of the target population.

Predictors of adherence to antihypertensive medication in northern United Arab Emirates

“…We found that male patients were more non-adherent to medication as compared with females and this finding is in agreement with other studies (25,27). In contrast, Holt et al showed no differences between the sexes regarding adherence to medication (28) and Shan et al found that females were more non-adherent to medication than males (29).…”

Antihypertensive Medication Adherence and Risk of Cardiovascular Disease Among Older Adults: A Population‐Based Cohort Study

“…Antihypertensive adherence might be a particular concern for older adults who have multiple chronic conditions 4, 5, 6, 8, 20. Many studies have examined major barriers and predictors of nonadherence among hypertensive patients,5, 7, 9, 11, 44, 45 and some focused on older adults 6, 46. Potential barriers to adherence among older adults can be classified into 3 categories: (1) patient‐related factors, including sociodemographics, psychosocial factors, comorbidities, cognitive ability, and health beliefs; (2) medication‐related factors, including the number of medications taken, adverse side effects, and complex medication regimens; and (3) other factors, including the patient‐prescriber relationship, access to medication and cost, and social support 6, 46.…”

Practical Approaches to Promote Adherence and Improve Blood Pressure Control in Black Patients

“…In a cross-sectional analysis of data from the Cohort Study of Medication Adherence among Older Adults (CoSMO) ( N = 2,194), the overall prevalence of low medication adherence did not differ according to sex ( P = 0.21) [ 19 ]. However, women who were nonadherent were more likely to report dissatisfaction with communication with their health care provider (OR = 1.75 women, 1.16 men; P = 0.13) and depressive symptoms (OR = 2.29 women, 0.93 men; P = 0.11).…”