title: Obesity Modifies the Association of Race/Ethnicity with Medication Adherence in the CARDIA Study.
abstract: OBJECTIVE
  To assess associations between race/ethnicity and medication adherence, and the potential modifying effects of weight category (normal, overweight, obese) in a community-based sample.
  
  
  METHODS
  We studied 1355 participants from the CARDIA (Coronary Artery Risk Development in Young Adults) study who were taking prescription medications in 2000-1. Medication adherence, as rated on the four-item Morisky medication adherence scale (score of 4 = maximum adherence), was reported for all participants.
  
  
  RESULTS
  The mean age ± SD of participants was 40 ± 3.6 years; 45% were African American and 36% were male. Overall, Whites had a higher proportion of maximum adherence than African Americans (59 vs 41%, respectively; p = 0.001). However, this difference was statistically significant only for participants within the normal weight category, of whom 54% of Whites were maximally adherent versus 35% of African Americans (p < 0.05). After adjustment for possible confounding covariates, race/ethnicity was associated with adherence only in those of normal weight: the odds ratio for maximum adherence in Whites versus African Americans of normal weight was 1.98 (95% CI 1.13, 3.47). Within race/ethnicity subgroups, weight category was associated with adherence in Whites but not in African Americans.
  
  
  CONCLUSIONS
  Weight category modifies the association of race/ethnicity with medication adherence. The high levels of non-adherence observed among African Americans and obese and overweight Whites bodes poorly for treatment of obesity-associated diseases such as cardiovascular disease or diabetes mellitus.
authors.affiliation: 1 Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA 2 Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Maribel
authors.initials: M
authors.lastname: Salas
authors.forename: Catarina I
authors.initials: CI
authors.lastname: Kiefe
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Schreiner
authors.forename: Yongin
authors.initials: Y
authors.lastname: Kim
authors.forename: Lucia
authors.initials: L
authors.lastname: Juarez
authors.forename: Sharina D
authors.initials: SD
authors.lastname: Person
authors.forename: O Dale
authors.initials: OD
authors.lastname: Williams