Volume 61, Issue 4 p. 558-564
Clinical Investigations

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

Elizabeth Holt PhD, MPH

Elizabeth Holt PhD, MPH

Center for Health Research, Ochsner Clinic Foundation, New Orleans, Louisiana

Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana

Search for more papers by this author
Cara Joyce MS

Cara Joyce MS

Department of Biostatistics and Bioinformatics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana

Search for more papers by this author
Adriana Dornelles ScD, MPH

Adriana Dornelles ScD, MPH

Center for Health Research, Ochsner Clinic Foundation, New Orleans, Louisiana

Search for more papers by this author
Donald Morisky ScD, MSPH

Donald Morisky ScD, MSPH

Department of Community Health Sciences, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, California

Search for more papers by this author
Larry S. Webber PhD

Larry S. Webber PhD

Department of Biostatistics and Bioinformatics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana

Search for more papers by this author
Paul Muntner PhD

Paul Muntner PhD

Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Louisiana

Search for more papers by this author
Marie Krousel-Wood MD, MSPH

Corresponding Author

Marie Krousel-Wood MD, MSPH

Center for Health Research, Ochsner Clinic Foundation, New Orleans, Louisiana

Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana

Department of Medicine, School of Medicine, Tulane University, New Orleans, Louisiana

Address correspondence to Marie Krousel-Wood, Ochsner Clinic Foundation, Center for Health Research, 1514 Jefferson Highway, New Orleans, LA 70121. E-mail: [email protected]Search for more papers by this author
First published: 25 March 2013
Citations: 83

Abstract

Objectives

To determine whether sociodemographic, clinical, healthcare system, psychosocial, and behavioral factors are differentially associated with low antihypertensive medication adherence scores in older men and women.

Design

Cross-sectional analysis of baseline data.

Setting

Cohort Study of Medication Adherence in Older Adults (N = 2,194).

Measurements

Low antihypertensive medication adherence was defined as a score less than 6 on the 8-item Morisky Medication Adherence Scale. Information on risk factors for low adherence was collected using telephone surveys and administrative databases.

Results

The prevalence of low medication adherence scores did not differ according to sex (women, 15.0%; men 13.1%; P = .21). In sex-specific multivariable models, having problems with medication cost and practicing fewer lifestyle modifications for blood pressure control were associated with low adherence scores in men and women. Factors associated with low adherence scores in men but not women were poor sexual functioning (odds ratio (OR) = 2.03, 95% confidence interval (CI) = 1.31–3.16 for men and OR = 1.28, 95% CI = 0.90–1.82 for women), and body mass index of 25.0 kg/m2 or more (OR = 3.23, 95% CI = 1.59–6.59 for men; OR = 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; 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; 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 customized to account for the sex of the target population.