Maribel Salas (Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA) Catarina I. Kiefe (Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA) Pamela J. Schreiner (Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA) Yongin Kim (Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA) Lucia Juarez (Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA) Sharina D. Person (Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA) O. Dale Williams (Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA)
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. Study design and setting: 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. Conclusion: 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.
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