title: The association between multimorbidity and poor adherence with cardiovascular medications.
abstract: Multimorbidity, defined as the presence of two or more chronic conditions, leads to a substantial public health burden. This study evaluated its association with adherence with cardiovascular medications in a Chinese population. A proportional stratified sampling was adopted to draw a representative sample of residents living in Henan Province, China. Interviewer-administered surveys were conducted by trained researchers. The outcomes included the number of chronic medical conditions, adherence with long-term medications (MMAS-8), and depressive symptoms (CESD-20). Binary logistic regression analysis was conducted to evaluate if medication adherence was associated with the presence of multimorbidity. From a total of 3866 completed surveys, the proportion of subjects having 0, 1 and ≥2 chronic conditions was 62.6%, 23.8% and 13.5%, respectively. Among 27.6% who were taking chronic medications, 66.6% had poor medication adherence (MMAS-8 score≤6). From binary logistic regression analysis, subjects with poor medication adherence were significantly associated with multimorbidity (adjusted odds ratio [AOR]: 1.35, 95% C.I. 1.02-1.78, p=0.037). Other associated factors included older age (AOR=1.04, 95% C.I. 1.03-1.05, p<0.001), smoking (AOR=1.63, 95% C.I. 1.16-2.30, p=0.005), family history of hypertension (AOR=1.51, 95% C.I. 1.19-1.93, p=0.001), and fair to poor self-perceived health status (AOR=2.15, 95% C.I. 1.69-2.74, p<0.001). Using medication adherence as the outcome variable, multimorbidity was significantly associated with poor drug adherence (AOR=1.34, 95% C.I. 1.02-1.77, p=0.037). Multimorbidity was associated with poorer medication adherence. This implies the need for closer monitoring of the medication taking behavior among those with multiple chronic conditions.
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.
authors.forename: Martin C S
authors.initials: MC
authors.lastname: Wong
authors.affiliation: Research Centre for Healthcare Management, School of Economics and Management, Tsinghua University, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.affiliation: Beijing Anzhen Hospital, Beijing, China.
authors.forename: Shenglai
authors.initials: S
authors.lastname: Zhou
authors.affiliation: Health Bureau of Weidong District, Pingdingshan, Henan Province, China.
authors.forename: Shiwei
authors.initials: S
authors.lastname: Li
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.
authors.forename: Xuefen
authors.initials: X
authors.lastname: Su
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.
authors.forename: Harry H X
authors.initials: HH
authors.lastname: Wang
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.
authors.forename: Roger Y N
authors.initials: RY
authors.lastname: Chung
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.
authors.forename: Benjamin H K
authors.initials: BH
authors.lastname: Yip
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.
authors.forename: Samuel Y S
authors.initials: SY
authors.lastname: Wong
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong. Electronic address: jlau@cuhk.edu.hk.
authors.forename: Joseph T F
authors.initials: JT
authors.lastname: Lau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000453:epidemiology*; D015897:Comorbidity; D003625:Data Collection / Q000379:methods; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D002317:Cardiovascular Agents
keywords: Associated factors; Cardiovascular medications; Medication adherence; Multimorbidity