Race, ethnicity, and sociocultural characteristics predict noncompliance with lipid-lowering medications.
BACKGROUND
Sociocultural factors that predict noncompliance with lipid-lowering medications are not well understood.


METHODS
Interviews and medical record review were conducted for 510 patients treated with lipid-lowering medications. Compliance with lipid-lowering medications was measured by patients' self-assessment of medication-taking practices.


RESULTS
Adjusted for age and sex, there was a higher frequency of noncompliance among Black and Hispanic subjects. Adjusted for age, sex, and race/ethnicity, noncompliance was associated with medication side effects, feelings of sadness or depression, fair or poor health status, primary use of a language other than English, single or divorced status, fewer and less frequent contact with friends, children in the household, and lower education. Independent predictors of noncompliance in multivariate models were side effects (OR = 3.9, P < 0.01), sadness or depression (OR = 1.9, P = 0.05), Black (OR = 3.7, P < 0.01, vs. White), Hispanic (OR = 6.3, P < 0.01, vs. White), single or divorced (OR = 2.1, P < 0.01), children in the household (OR = 1.5 per child, P < 0.01), and lack of health insurance (OR = 2.4, P = 0.05).


CONCLUSIONS
Unmarried status, feelings of sadness or depression, lack of insurance, and children in the household were independently associated with poorer compliance with lipid-lowering medications in this urban population. Nonetheless, higher noncompliance among minority patients persisted independently of these and other specific social, cultural, and economic factors.
Kaplan
Robert C
RC
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA. rkaplan@aecom.yu.edu
Bhalodkar
Narendra C
NC
Brown
Edward J
EJ
White
Jessica
J
Brown
David L
DL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000069059:Atorvastatin; D005260:Female; D006304:Health Status; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance / Q000208:ethnology / Q000706:statistics & numerical data*; D011758:Pyrroles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D019821:Simvastatin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014505:Urban Population
D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin; D019821:Simvastatin