The impact of medication use in a multicomponent intervention: results from the WISEWOMAN program.
OBJECTIVE
To assess the impact of medication use on improvements in coronary heart disease (CHD) risk among WISEWOMAN participants.


METHODS
Pre-post analysis.


METHODS
WISEWOMAN projects operating at the local level in 8 states.


METHODS
WISEWOMAN participants with baseline and one-year follow-up data with at least one abnormal risk factor at baseline (N=2385; 24% of women with baseline visits).


METHODS
WISEWOMAN provides low-income uninsured women with CHD risk factor screenings, lifestyle interventions, access to medications, and referral services.


METHODS
One-year changes in blood pressure, cholesterol, and 10-year CHD risk by medication status.


METHODS
Regression analysis was used to estimate risk factor changes by medication status (newly medicated women, women medicated at baseline, or not medicated women) and quantify the percentage of improvements in risk factors attributed to medication use.


RESULTS
Participants experienced statistically significant improvements in systolic (12.6 mm Hg) and diastolic (9.7 mm Hg) blood pressure, total (25.7 mg/dl) and HDL (4.9 mg/dl) cholesterol, and 10-year CHD risk (11.6%). Medication use was responsible for 4% to 5% of the reduction in blood pressure, 32% of the reduction in total cholesterol, 3% of the increase in HDL cholesterol, and 31 % of the reduction in 10-year CHD risk.


CONCLUSIONS
Some of the improvements in CHD risk factors can be attributed to medication use; however, the majority of improvements are likely driven by a combination of other factors, including screenings, risk factor counseling, and lifestyle interventions.
Khavjou
Olga A
OA
RTI International, Health, Social and Economics Research, Research Triangle Park, North Carolina 27709, USA. okhavjou@rti.org
Finkelstein
Eric A
EA
Will
Julie C
JC
D000328:Adult; D001794:Blood Pressure; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000517:prevention & control* / Q000628:therapy*; D004363:Drug Utilization; D005260:Female; D006293:Health Promotion / Q000458:organization & administration; D006297:Health Services Accessibility / Q000458:organization & administration; D006302:Health Services Research; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors
D002317:Cardiovascular Agents; D002784:Cholesterol