DOCUMENTS

papers

Antihypertensive adherence and drug class among Asian Pacific Americans

Published: June 1, 2007
Category: Papers
Authors: Chung RS, Davis J, Gelber RP, Gronley K, Seto TB, Taira DA
Country: United States
Language: null
Type: Population Health
Settings: Government, Hospital

Ethn Health 12:265-281.

Hawaii Medical Service Association, Honolulu, HI, USA

OBJECTIVE: Research on adherence has emphasized the need to consider patient ethnicity when developing adherence plans. The objective of this study is to identify predictors of adherence for specific groups, particularly Asian Americans and Pacific Islanders.

METHODS: We examined the factors, including drug class, associated with antihypertensive adherence for 28,395 adults in Hawaii (July 1999-June 2003) using health plan administrative data. The population included Japanese (n=13,836), Filipino (n=3,812), Chinese (n=2,280), Korean (n=450), part-Hawaiian (n=3,746) and white (n=3,920) patients. Members with antihypertensive medication in their possession >or=80% of the time were considered adherent. Multivariable logistic regression models were used to identify factors associated with adherence.

RESULTS: Overall adherence rates were less than 65% among all racial/ethnic groups. After adjustment for patient age, gender, morbidity level, health plan type, isle of residence, comorbidities and year of treatment, Japanese were more likely than whites to adhere to antihypertensive therapy [OR=1.21 (1.14-1.29)], whereas Filipino [OR=0.69 (0.64-0.74)], Korean [OR=0.79 (0.67-0.93)] and Hawaiian [OR=0.84 (0.78-0.91)] patients were less likely to adhere. These results were consistent across therapeutic class. Other patient factors associated with lower adherence included younger age, higher morbidity and history of heart disease. Patient factors were also significantly related to adherence, including gender and seeing a sub-specialist. Seeing a physician of the same ethnicity did not appear to improve adherence.

CONCLUSIONS: Our findings of substantial disparities among Asian Pacific American subgroups highlight the need to examine subgroups separately. Future qualitative research is needed to determine appropriate interventions, particularly for Filipino, Korean and Hawaiian patients.

PMID: 17454100

Population Markers,Medications,Prescription Drug Use and Expenditures,United States,Adolescent,Adult,Age Factors,80 and over,Antihypertensive Agents/classification,Co-morbidity,Cross-Cultural Comparison,European Continental Ancestry Group/psychology,Gender,Hawaii/epidemiology,Hypertension/drug therapy,Insurance,Pharmaceutical Services/statistics & numerical data,Logistic Models,Middle Aged,Mulivariate Analysis,Odds Ratio,Risk Factors

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